使用病作为结果来确定2型糖尿病的HbA1c诊断值
Alexandra E Butler1, Steven C Hunt2, Eric S Kilpatrick3
1Research Department, Royal College of Surgeons Ireland Bahrain, Adliya, Bahrain.
Diabetes & metabolic syndrome
|April 14, 2024
概括
目前用于诊断糖尿病的血红蛋白A1c (HbA1c) 值不需要改变,以考虑到糖尿病病风险. 这项研究发现没有HbA1c水平低于7.0%有效预测高患病率人群中的病.
科学领域:
- 内分泌学和新陈代谢学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 糖尿病 诊断 诊断 糖尿病 诊断
背景情况:
- 使用血红蛋白A1c (HbA1c) 确立的2型糖尿病 (T2D) 诊断值为6.5% (48 mmol/mol),主要基于视网膜病变的患病率.
- 预测糖尿病病,一种不太常见的早期并发症的HbA1c值仍然不清楚.
- 调查糖尿病患病率高的人群对于重新评估病的诊断值至关重要.
研究的目的:
- 确定是否可以建立特定的HbA1c诊断值来预测病.
- 在没有已知的T2D的个体中,比较HbA1c对脏病与视网膜病的预测值.
- 评估HbA1c切割点,以预测糖尿病患病率高的人群中的病.
主要方法:
- 分析卡塔尔生物银行2920名健康个体的尿白蛋白:肌素比率 (UACRs),HbA1c≥5.6%.
- 病症被定义为UACR≥30 mg/g.
- 对脏病的HbA1c预测使用从5.7%到7.0%不等的切割点进行评估.
主要成果:
- 随着HbA1c的增加 (p < 0.01),观察到异常UACR患病率增加的显著趋势,主要是由HbA1c≥7.0% (53 mmol/mol) 的个体驱动的.
- 异常UACR的几率比率在5.7%至6.9%的HbA1c值之间是可比的,狭窄的范围为1.2-1.6.6.
- 接受器下运行区域特征曲线分析没有确定任何HbA1c值低于7.0%作为脏病的最佳预测指标.
结论:
- 没有发现HbA1c值低于7.0%可以预测脏病的患病率增加,即使在患病率高的人群中也是如此.
- 现有的基于视网膜病变的HbA1c诊断值为6.5%,不需要调整以纳入糖尿病病风险.
- 目前的HbA1c诊断标准似乎足以识别有网膜病变和病变风险的个体.
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