【摘要】 目的探讨早餐后2h血糖(2hPG)在糖尿病筛查中合适的切点及其在糖尿病筛查中的应用。方法选择四川泸天化集团公司6 387名职工的糖尿病流行病学调查数据,以WHO诊断标准作为金标准,采用诊断试验评价方法及标准工作曲线(ROC)进行分析。结果与检测空腹血糖(FPG)比较,检测早餐后2hPG具有更好的灵敏度和特异度;FPG和早餐后2hPG的ROC曲线下面积,男性分别为0.79,0.962,女性分别为0.77,0.957,两者间差异有统计学意义(P=0.000);当早餐后2hPG取6.65 mmol/L时,具有最大的灵敏度和特异度,其中男性为97.2和84.4,在女性为93.5和89.1;一致性率(Youden’s index)男性为0.83,女性为0.82;当早餐后2hPG取>6.65 mmol/L时,所筛查出的糖耐量减低(IGT)人数几乎是FPG>5.6 mmol/L筛查出的2倍。结论早餐后2hPG比FPG在筛查早期糖尿病人时有更好的灵敏度和特异度,当切点取6.65时能更好的筛查出IGT人群,建议将早餐后2hPG作为糖尿病筛查的指标。更多还原

【Abstract】 Objective To discuses the cut-off point of 2-hours postprandial glucose and its application on screening for undiagnosed population.Methods The epidemiology data of people in chemical industrial of Luzhou,Sichuan was reanalyzed by using diagnostic test appraise method and the receiver characteristic(ROC) curve with WHO criteria as gold standard.Results Comparing with FPG,2-hours postprandial glucose had high sensitivity and specificity;The area of ROC curve was 0.79 with FPG and 0.962 with 2-h postprandial glucose in male and 0.77 with FPG and 0.957 with 2-h postprandial glucose in female,the difference had statistic significant;When cut-off point of 2-h postprandial glucose was at 6.65?mmol/L,the maximal sensitivity was 97.2% and specificity was 84.4% in male,93.5% and 89.1% in female.The Youden’s index was 0.83 and 0.82 for male and female;The number of IGT was nearly 2 times when using 2-h postprandial glucose ≥6.65?mmol/L than using FPG≥5.6?mmol/L.Conclusion 2-h postprandial glucose has higher sensitivity and specificity than FPG when screening diabetes;When cut-off point is 6.65?mmol/L,using 2-h postprandial glucose can screening out more IGT than FPG.It is suggested that 2-h postprandial glucose can be an efficient index when screening diabetes.更多还原