对采用空腹指尖毛细血管血血糖筛查糖尿病和糖耐量减低偏性的研究

Abstract

目的 探讨采用空腹指尖毛细血管血血糖(FBG)≥6.1 mmol/L作为界定值筛查糖尿病(DM)和糖耐量减低(IGT)出现的偏性. 方法 筛查设A、B、C、D 四个自然人群组. 各组分别为8151、9168、9096及8355人.A、B、C三组均先做FBG,其界定值依次为6.1 mol/L、5.5 mol/L、5.0 mol/L,各组超过或等于其界定值者再做OGTT,筛查DM和IGT.D组则直接做OGTT筛查DM和IGT.DM和IGT诊断按照WHO1999年标准. 结果 A、B、C、D 四组DM的检出率分别为6.91%、8.21%、8.30%、8.32%,IGT的检出率分别为2.48%、6.10%、 8.05%、 8.16%.A组行OGTT的人数比例占被调查总人群的11.3%,与D组比较,DM、IGT漏检率分别为 16.95%、69.61%;B组行OGTT的人数比例占被调查总人群的27.79%,与D组比较,DM、IGT漏检率分别为1.32%和25.25%; C组行OGTT的人数比例占被调查总人群的58.37%,与D组比较,DM、IGT漏检率分别为0.24%和1.35%. 结论 选择FBG≥5.0 mmol/L作为界定值,是开展糖尿病流行病学调查获得DM和IGT患病率的成本-效益-效果最佳方案.

Objective To study the deflection of screening diabetes and IGT by fasting fingertip blood glucose.Methods The people(n=34 770) aged 40~74 years from Baoan district of Shenzhen city in China were randomized into A,B,C and D groups.When the fasting fingertip blood glucose exceeded the defined values of A group≥6.1 mmol/L,B group ≥5.5 mmol/L,C group ≥5.0 mmol/L,the blood glucose of the people was measured after 2 h oral glucose load(75 g in 250~300 ml of water for adults), but the blood glucose of all the D group people was measured after 2 h oral glucose load.The 1985 WHO criteria was used to diagnose DM and IGT.Results The detection rates of DM and IGT of A,B,C and D groups were 6.91%,8.21%,8.30%,8.32% and 2.48%,6.10%,8.05%,8.16% respectively. The proportion of oral glucose load in A group was 11.6%,and the escape rates of DM and IGT were 16.95%,69.61% respectively.The proportion of oral glucose load in B group was 27.79%,and the escape rates of DM and IGT were 1.32% and 25.25% respectively.The practice proportion of oral glucose load in C group was 58.37%,and the escape rates of DM and IGT were 0.24% and 1.35% respectively.Conclusion The escape rates of DM and IGT were 16.95% and 69.23%;1.32% and 25.25%;and 0.24% and 1.35%,when the fasting fingertip blood glucose(≥6.1,) ≥5.5,and ≥5.0 mmol/L respectively.It is better methods for cost-effect ratio to choose the fasting fingertip blood glucose ≥5.0 mmol/L as oral glucose load indicator in filtration tests for type 2 diabetes.