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【文摘发布】HbA1c作为2型糖尿病筛查指标的可靠
Author：Bennett CM, Guo M, Dharmage SC.
Resource: Diabet Med. 2007 Apr;24(4):333-43.
Abstract：Aim To assess the validity of glycated haemoglobin A(1c) (HbA(1c)) as a screening tool for early detection of Type 2 diabetes. Methods Systematic review of primary cross-sectional studies of the accuracy of HbA(1c) for the detection of Type 2 diabetes using the oral glucose tolerance test as the reference standard and fasting plasma glucose as a comparison. Results Nine studies met the inclusion criteria. At certain cut-off points, HbA(1c) has slightly lower sensitivity than fasting plasma glucose (FPG) in detecting diabetes, but slightly higher specificity. For HbA(1c) at a Diabetes Control and Complications Trial and UK Prospective Diabetes Study comparable cut-off point of >/= 6.1%, the sensitivity ranged from 78 to 81% and specificity 79 to 84%. For FPG at a cut-off point of >/= 6.1 mmol/l, the sensitivity ranged from 48 to 64% and specificity from 94 to 98%. Both HbA(1c) and FPG have low sensitivity for the detection of impaired glucose tolerance (around 50%). Conclusions HbA(1c) and FPG are equally effective screening tools for the detection of Type 2 diabetes. The HbA(1c) cut-off point of > 6.1% was the recommended optimum cut-off point for HbA(1c) in most reviewed studies; however, there is an argument for population-specific cut-off points as optimum cut-offs vary by ethnic group, age, gender and population prevalence of diabetes. Previous studies have demonstrated that HbA(1c) has less intra-individual variation and better predicts both micro- and macrovascular complications. Although the current cost of HbA(1c) is higher than FPG, the additional benefits in predicting costly preventable clinical complications may make this a cost-effective choice.
PMID: 17367307 本人认领，48小时未提交，请其他战友自由认领 Title：HbA(1c) as a screening tool for detection of Type 2 diabetes: a systematic review.題目：HbA1c作为2型糖尿病筛查指标的可靠性：一项系统回顧 Author：Bennett CM, Guo M, Dharmage SC.作者：Bennett CM, Guo M, Dharmage SC.Resource: Diabet Med. 2007 Apr;24(4):333-43.來源：Diabet Med. 2007 Apr;24(4):333-43.Abstract：摘要Aim To assess the validity of glycated haemoglobin A(1c) (HbA(1c)) as a screening tool for early detection of Type 2 diabetes.目的是評估 HbA(1c)作為2型糖尿病早期篩選的可靠性。Methods 方法Systematic review of primary cross-sectional studies of the accuracy of HbA(1c) for the detection of Type 2 diabetes using the oral glucose tolerance test as the reference standard and fasting plasma glucose as a comparison. 系統性的回顧先前關于HbA(1c)的研究。以OGTT作為參考標準,以FPG作為對照.Results 結果Nine studies met the inclusion criteria. At certain cut-off points, HbA(1c) has slightly lower sensitivity than fasting plasma glucose (FPG) in detecting diabetes, but slightly higher specificity.九項研究符合標準.取某些特定點,會發現HbA(1c)比FPG有較低的敏感性和較高的特異性. For HbA(1c) at a Diabetes Control and Complications Trial and UK Prospective Diabetes Study comparable cut-off point of >/= 6.1%, the sensitivity ranged from 78 to 81% and specificity 79 to 84%. 英國糖尿病預防會?將HbA(1c)的取舍點定在>/= 6.1%來控制糖尿病和預測并發癥,其敏感度為78到81%,特異性為79到84%. For FPG at a cut-off point of >/= 6.1 mmol/l, the sensitivity ranged from 48 to 64% and specificity from 94 to 98%. FPG的取舍點定在>/= 6.1 mmol/l時,敏感度為48到64%,特異性為94到98%. Both HbA(1c) and FPG have low sensitivity for the detection of impaired glucose tolerance (around 50%). HbA(1c)和FPG在檢測糖耐量減低方面有較低的敏感度(大約50%).Conclusions 結論HbA(1c) and FPG are equally effective screening tools for the detection of Type 2 diabetes. HbA(1c)和FPG作為2型糖尿病檢測的篩選工具同樣有效.The HbA(1c) cut-off point of > 6.1% was the recommended optimum cut-off point for HbA(1c) in most reviewed studies; however, there is an argument for population-specific cut-off points as optimum cut-offs vary by ethnic group, age, gender and population prevalence of diabetes. 大多數回顧研究將HbA(1c)> 6.1%作為推薦的取舍點,但是在不同民族,年龄,性别和糖尿病流行种群中人群特异性的最优取舍点选择上仍存在争议.Previous studies have demonstrated that HbA(1c) has less intra-individual variation and better predicts both micro- and macrovascular complications. 先前的研究顯示HbA(1c)在個體內變異很小,可以更好的預測毛細血管和大血管并發癥.Although the current cost of HbA(1c) is higher than FPG, the additional benefits in predicting costly preventable clinical complications may make this a cost-effective choice.盡管現在HbA(1c)的價錢比FPG貴,但是在預防嚴重的可預防的臨床并發癥方面帶來的額外好處使之成為劃算的選擇. 題目：HbA1c作为2型糖尿病筛查指标的可靠性：一项系统回顧
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作者:admin@医学,生命科学 2010-11-06 17:11
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