The deflection of filtration rate of type 2 diabetes by fasting fingertip blood glucose testing

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.中文核心期刊要目总览(PKU)中国科学引文数据库(CSCD)06422-4241