HbA1c作为2型糖尿病筛查指标的可靠性：一项系统回顾

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Title：HbA(1c) as a screening tool for detection of Type 2 diabetes: a systematic review.
题目：HbA1c作为2型糖尿病筛查指标的可靠性：一项系统回顾
Author：Bennett CM, Guo M, Dharmage SC.作者：Bennett CM, Guo M, Dharmage SC.Resource: Diabet Med. 2007 Apr;24(4):333-43.
来源：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.目的是评估 HbA(1c)作为2型糖尿病早期筛选的可靠性。
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. 系统性的回顾先前关于HbA(1c)的研究。以OGTT作为参考标准,以FPG作为对照.
Results 结果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.九项研究符合标准. 取某些特定点,会发现HbA(1c)比FPG有较低的敏感性和较高的特异性. 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%. 英国糖尿病预防会?将HbA(1c)的取舍点定在>/= 6.1%来控制糖尿病和预测并发症,其敏感度为78到81%,特异性为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的取舍点定在>/= 6.1 mmol/l时,敏感度为48到64%,特异性为94到98%. Both HbA(1c) and FPG have low sensitivity for the detection of impaired glucose tolerance (around 50%). HbA(1c)和FPG在检测糖耐量减低方面有较低的敏感度(大约50%).
Conclusions 结论HbA(1c) and FPG are equally effective screening tools for the detection of Type 2 diabetes. HbA(1c)和FPG作为2型糖尿病检测的筛选工具同样有效.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. 大多数回顾研究将HbA(1c)> 6.1%作为推荐的取舍点,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. 先前的研究显示HbA(1c)在个体内变异很小,可以更好的预测毛细血管和大血管并发症.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.尽管现在HbA(1c)的价钱比FPG贵,但是在预防严重的可预防的临床并发症方面带来的额外好处使之成为划算的选择.

题目：HbA1c作为2型糖尿病筛查指标的可靠性：一项系统回顾
作者：Bennett CM, Guo M, Dharmage SC.
来源：Diabet Med. 2007 Apr;24(4):333-43.
摘要
目的是评估 HbA(1c)作为2型糖尿病早期筛选的可靠性。
方法
系统性的回顾先前关于HbA(1c)的研究。以OGTT作为参考标准,以FPG作为对照.
结果
九项研究符合标准.取某些特定点,会发现HbA(1c)比FPG有较低的敏感性和较高的特异性.
英国糖尿病预防会?将HbA(1c)的取舍点定在>/= 6.1%来控制糖尿病和预测并发症,其敏感度为78到81%,特异性为79到84%.
FPG的取舍点定在>/= 6.1 mmol/l时,敏感度为48到64%,特异性为94到98%.
HbA(1c)和FPG在检测糖耐量减低方面有较低的敏感度(大约50%).
结论
HbA(1c)和FPG作为2型糖尿病检测的筛选工具同样有效.
大多数回顾研究将HbA(1c)> 6.1%作为推荐的取舍点,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.先前的研究显示HbA(1c)在个体内变异很小,可以更好的预测毛细血管和大血管并发症.尽管现在HbA(1c)的价钱比FPG贵,但是在预防严重的可预防的临床并发症方面带来的额外好处使之成为划算的选择.