糖尿病诊断的禁食葡萄糖和视网膜病变之间的关系:三项基于人口的横截面研究
Tien Y Wong1, Gerald Liew, Robyn J Tapp
1Centre for Eye Research Australia, University of Melbourne, VIC, Australia. twong@unimelb.edu.au
Lancet (London, England)
|March 4, 2008
概括
目前基于禁食血葡萄糖 (FPG) 的糖尿病诊断标准可能无法有效识别糖尿病视网膜病变. 建议重新评估这些值,以改善患者护理和诊断糖尿病并发症.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 目前糖尿病的诊断标准依赖于血糖值来检测视网膜病变.
- 之前支持这些值的研究在检测视网膜病变方面存在局限性.
- 需要更新数据来评估禁食血葡萄糖 (FPG) 和视网膜病变之间的关系.
研究的目的:
- 提供关于FPG和视网膜病变之间的关系的最新数据.
- 评估目前FPG值的诊断准确性,以识别流行和发生的视网膜病变.
主要方法:
- 分析了三个大型的多民族成年人群:蓝山眼睛研究 (BMES),澳大利亚糖尿病,肥胖和生活方式研究 (AusDiab) 和动脉样硬化多民族研究 (MESA).
- 视网膜病变是由视网膜照片诊断的,并使用修改后的Airlie House分类来分类.
- 测量了禁食静脉血葡萄糖度.
主要成果:
- 视网膜病变的发病率:11.5% (BMES),9.6% (AusDiab),15.8% (MESA). 在美国,视网膜病变的发病率是1.5% (BMES),9.6% (AusDiab),15.8% (MESA).
- 对统一的血糖值有不一致的证据;观察到连续的关系.
- 7.0 mmol/L的FPG切线对于检测视网膜病变的灵敏度低 (<40%),具有高特异性 (80.8-95.8%).
- 对于FPG和视网膜病变的ROC曲线下的面积很低 (0.56-0.61).
结论:
- 在不同人群中没有明确,一致的视网膜病变存在或发生率的血糖值.
- 目前的FPG糖尿病诊断切线在识别有或没有视网膜病变的个体方面缺乏准确性.
- 基于这些发现,重新评估糖尿病诊断标准是有必要的.
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