背景在2型糖尿病(T2DM)发生率持续升高且发病年龄不断降低的大环境下,早期筛查与确诊的重要性越来越明显。有研究发现血清晚期糖基化终末产物肽(AGE-P)进行T2DM早期筛查的优势高于糖化血红蛋白(HbA1c)。目的验证血清AGE-P水平在维吾尔族人群T2DM早期筛查中的应用价值。方法选择2018年2月-2019年12月于新疆维吾尔自治区人民医院行健康体检的维吾尔族人群1100例。依据糖耐量试验(OGTT)结果将受试者分为糖尿病组(n=75)和正常糖耐量组(n=1025)。比较两组年龄、腰围、体质指数(BMI)、舒张压(DBP)、收缩压(SBP)及血清空腹血糖(FPG)、餐后2 h血糖(2 hPG)、HbA1c、AGE-P、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平和尿素氮、尿酸、血肌酐。绘制血清FPG、2 hPG、HbA1c、AGE-P筛查维吾尔族人群发生T2DM的受试者工作特征曲线(ROC曲线)。结果糖尿病组年龄、BMI、腰围、DBP、SBP均高于正常糖耐量组(P<0.05)。糖尿病组血清FPG、2 hPG、HbA1c、TC、TG、LDL-C水平高于正常糖耐量组(P<0.05);两组血清AGE-P、HDL-C水平及尿素氮、尿酸、血肌酐水平比较,差异无统计学意义(P>0.05)。血清FPG、2 hPG筛查维吾尔族人群发生T2DM的约登指数分别为0.854、0.814,灵敏度分别为88.0%、82.7%,特异度分为97.4%、98.7%,AUC分别为0.957[95%CI(0.943,0.968),Z=25.718,P<0.001]、0.937[95%CI(0.921,0.951),Z=21.222,P<0.001];血清AGE-P筛查维吾尔族人群发生T2DM的约登指数为0.055,灵敏度为74.7%,特异度为19.8%,AUC为0.507[95%CI(0.477,0.537),Z=0.203,P=0.839]。结论血清AGE-P水平在T2DM患者中并未表现出明显的升高,且其筛查T2DM的特异度、约登指数均较低,因此不建议作为维吾尔族T2DM高危人群筛查的指标,在维吾尔族人群糖尿病筛查中仍然建议使用FPG、OGTT等传统糖尿病检测指标。Background In view of increasing incidence and decreased age of onset of type 2 diabetes mellitus(T2MD),early screening for T2MD for getting a timely diagnosis is becoming ever-growing important.Some studies have found that serum advanced glycation end product peptides(AGE-P)are superior to glycosylated hemoglobin(HbA1c)in terms of early screening for T2MD.Objective To explore the value of serum AGE-P in early screening for T2MD in Uygur population.Methods A total of 1100 Uygur health check-up examinees were recruited from People's Hospital of Xinjiang Uygur Autonomous Region from February 2018 to December 2019 and divided into diabetic group(n=75)and normal glucose tolerance group(n=1025)by the results of an OGTT.Intergroup comparisons were performed in terms of age,waist circumference,BMI,diastolic blood pressure,systolic blood pressure,fasting plasma glucose(FPG),2-h postprandial plasma glucose(2 hPG),HbA1c,AGE-P,total cholesterol(TC)and triglyceride,high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C),urea nitrogen,uric acid and serum creatinine.ROC curves of serum FPG,2 hPG,HbA1c and AGE-P in screening for T2DM were plotted.Results Compared to those with normal glucose tolerance,diabetic cases had greater average age,and higher average BMI,waist circumference,DBP and SBP(P<0.05).Moreover,they also demonstrated higher average levels of serum FPG,2 hPG,HbA1c,TC,triglyceride,and LDL-C(P<0.05).However,serum levels of AGE-P,HDL-C,urea nitrogen,uric acid and serum creatinine were similar in the two groups(P>0.05).In screening for T2DM,the Youden's index of serum FPG was 0.854,with 88.0%sensitivity and 97.4%specificity,and AUC of 0.957〔95%CI(0.943,0.968),Z=25.718,P<0.001〕.The Youden's index of serum 2 hPG was 0.814,with 82.7%sensitivity and 98.7%specificity,and AUC of 0.937〔95%CI(0.921,0.951),Z=21.222,P<0.001〕.The Youden's index of serum AGE-P was 0.055,with 74.7%sensitivity and 19.8%specificity,and AUC of 0.507〔95%CI(0.477,0.537),Z=0.203,P=0.839〕.Conclus
机构地区新疆维吾尔自治区人民医院内分泌科
出处《中国全科医学》 CAS 北大核心 2021年第18期2309-2313,共5页Chinese General Practice
关键词糖尿病 2型 晚期糖基化终末产物肽 葡糖耐量试验 维吾尔族 早期诊断 筛查Diabetes mellitus,type 2 Advanced glycation end products peptides Glucose tolerance test Uygur nationality Early diagnosis Screening
分类号R587.1 [医药卫生—内分泌]
