Effect of HbA_1c combined FPG on screening diabetes in health check-up

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• 作者：Li-Juan Li^a ; Jing-Xia Zhou^c ; Hong-Tao Chen^d ; Yan-Ling Song^b ; Yao-Ming Xue^a ; ^{Yaomingxue@126.com}
• 关键词：HbA1c ; Diabetes ; Screening ; Health checkup
• 刊名：Asian Pacific Journal of Tropical Medicine
• 出版年：2012
• 期刊代码：pca68_19957645
• 类别：med
• 出版时间：June, 2012
• 卷：5
• 期：6
• 页码：472-475
• 文件大小：266 K

摘要

Objective

To appraise the effectiveness of HbA_1c and fasting plasma glucose (FPG) on screening diabetes in health check-up.

Methods

A total of 1鈥?37 individuals (male 850, female 487), aged 27 to 91 years with HbA_1c test were included. Participates with HbA_1c 猢?.0%or FPG猢?.1 mmol/L underwent oral glucose tolerance test (OGTT). Diabetes mellitus was diagnosed according to the criteria of WHO in 1999, FPG猢?.0 mmol/L and/or OGTT 2 h-postload plasm glucose (2 h-PG)猢?1.1 mmol/L. The sensitivity and specificity of HbA_1c thresholds and FPG or combination test on screening of diabetes were analyzed.

Results

A total of 842 subjects had HbA_1c <6.0%, in which 32 had isolated FPG猢?.1 mmol/L, of 495 had HbA_1c猢?.0%. Subjects with HbA_1c猢?.0%had significant increased disorder indexes than those with HbA_1c<6.0%. 527 subjects who had HbA_1c猢?.0%or FPG猢?.1 mmol/L underwent OGTT. A total of 234 subjects were newly diagnosed diabetes, including 123 (123/234, 52.56%) with FPG猢?.0 mmol/L, and 111 subjects (111/234, 47.43%) with isolated 2 h-PG猢?1.1 mmol/L. Among 234 new diabetes, 91.88%(215 subjects) had HbA_1c猢?.3%, and 77.40%(181 subjects) had HbA_1c猢?.5%. HbA_1c猢?.3%combined FPG 猢?.0 mmol/L increased the positive rate of newly diagnosed diabetes from 91.88%to 96.58%.

Conclusions

HbA_1c is a practical and convenient tool for screening undiagnosed diabetes in routine health check-up of a large population. Combined use of HbA_1c猢?.3%and/or FPG猢?.0 mmol/L is efficient for early detection of diabetes.