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Objective: blood sugar is the key indicators for the diagnosis of diabetes, but there are fluctuations, poor reproducibility, by objective factors large drawbacks, HbA1C can reflect changes in blood sugar levels, with good stability, by objective factors and other advantages, it is this The study was designed to investigate the HbA1C whether the diagnostic criteria for diabetes and its diagnosis cut-off point. METHODS: March 2008 - January 2010, the Second Affiliated Hospital of Dalian Medical treatment line OGTT test and HbA1C check and meet certain standards of subjects, on the part of the subjects of the FBG, PG2h, HbA1C The receiver operating characteristic curve (ROC curve) analysis, the diabetes blood glucose diagnostic criteria corresponding to HbA1C cut-off point. The proceeds HbA1c cut-off point as the point of diagnosis of diabetes community, follow-up to another part of the glucose regulation impaired, every 1-3 month follow-up, the observed outcome of the situation of the glucose metabolism (blood sugar as diagnostic criteria) for the development of diabetes would be suspended if the follow-up, did not progress to diabetes continue to follow-up to March 2010, in order to determine the of the HbA1C diagnosis critical point is appropriate. Results: 1. Collected 377 cases of subjects, its ROC curve HbA1c cut-off point and diabetes blood glucose diagnostic criteria corresponding to a value of 6.3%, the sensitivity of the diagnosis of diabetes was 67.8%, specificity of 72.7%. 2 follow-up collection to follow-up, 279 cases, follow-up HbA1C levels divided into HbA1c ≥ 6.3% group and HbA1C LT; 6.3% group, as a follow-up blood glucose diagnostic criteria for diabetes, two groups of diabetes prevalence rates were : 74.42%, 31.09% (X2 = 45.237, P = 0.000), mean follow-up time were: 4.69 ± 0.39 months, 4.79 ± 0.23 months (t = -0.249, P = 0.803). 3. HbA1C6.3% as the boundary point, the ability to diagnose diabetes than the FBG strong, but weaker than PG2h, such as the United FBG, its diagnostic capabilities the still PG2h FBG weak. 279 cases were followed up by pure HbA1C levels can be diagnostic for diabetes the accounting for 30.82%, simply FBG levels can be diagnostic for diabetes the accounting for 15.77% (X2 = 22.849, p 0.000); 279 patients were followed up by, the last follow-up when the OGTT test, there were 148 cases, based solely on HbA1C levels can be diagnosed as diabetes accounted for 31.08%, simply based on PG2h diagnosis of diabetes, accounting for 40.54% (X2 = 16.861, P = 0.000); HbA1c and FBG can be diagnosed as diabetes accounted for 38.51%, according to PG2h FBG can be diagnosed as diabetes accounted for 46.62% (X2 = 43.266, P = 0.000). 4 subjects were stratified according to age factor and draw the ROC curves obtained with diabetes blood glucose diagnostic criteria corresponding HbA1c cut-off point ≥ 70 year-olds to 6.4%, lt; 70-year-olds was 6.2%. The former diagnosis of diabetes sensitivity of 66.7% and a specificity of 71.0%; latter diagnosis of diabetes a sensitivity of 73.5% and a specificity of 68.8%. 5 of the 279 patients were followed up in the ≥ 70-year-old crowd, such as HbA1C of 6.3%, 6.4% as a critical point of diagnosis of diabetes, the rate of diagnosis of diabetes were: 49.25%, 41.79% (X2 = 49.560, P = 0.000 ); lt; 70-year-old population, such as HbA1C 6.3%, 6.2% as a critical point of diagnosis of diabetes, the rate of diagnosis of diabetes were: 25.00%, 32.08% (X2 = 149.674, P = 0.000). 6 in the follow-up of 279 cases, 70 years old, is bounded to HbA1C6.4%, its ability to diagnose diabetes than the FBG strong, with PG2h, PG2h joint FBG, such as the United FBG diagnostic capabilities PG2h of United FBG was no further strengthened. ≥ 70 years old, simple HbA1C levels can diagnosis for diabetes accounted for 41.79%, simply FBG can be diagnostic for diabetes, accounting for 25.37% (X2 = 20.000, p 0.000); in the last follow-up carried out the OGTT test of 148 cases ≥ 70 years of age in 38 cases, based solely on HbA1C levels can be diagnosed as diabetes accounted for 42.11%, simply based on PG2h diagnosis of diabetes, accounting for 50.00% (X2 = 0.432, P = 0.743); United PG2h FBG can be diagnosed with diabetes accounted for 57.89% (57.89% vs 42.11% X2 = 3.317, P = 0.100), the HbA1C United FBG can be diagnosed as diabetes accounted for 47.37% (47.37% vs 57.89% X2 = 5.546, P = 0.388). Lt; 70 years of age, to HbA1C6.2% critical point, its ability to diagnose diabetes than the FBG strong, with the same PG2h, more PG2h joint FBG weak, such as the United FBG the diagnostic capabilities with the United PG2h FBG. Simply based on HbA1C levels can be diagnostic for diabetes the accounting for 32.08%, simply FBG can be diagnostic for diabetes, accounting for 12.74% (X2 = 7.829, p 0.000); in the last follow-up carried out the OGTT test the 148 cases, the lt; 70-year-old 110 cases based solely on HbA1C levels can be diagnosed as diabetes accounted for 31.82% pure based on PG2h diagnosis of diabetes accounted for 37.27% (X2 = 14.327, P = 0.377); United PG2h FBG can be diagnosed as diabetes accounted for 42.73% ( 42.73% vs 31.82% X2 = 17.280, P = 0.000), HbA1C FBG can be diagnosed as diabetes accounted for 37.27% (37.27% vs. 42.73% X2 = 28.880, P = 0.327). Conclusion: 1.HbA1C can be used for the diagnosis of diabetes, the diagnostic cut-off point ≥ 70 to 6.4%, lt; 6.2% in 70 years. 2, HbA1C strong ability to than the FBG diagnosis of diabetes in the ≥ 70-year-old crowd, HbA1C alternative OGTT; lt; 70-year-old crowd, HbA1C alternative PG2h for the diagnosis of diabetes. The age stratified HbA1C is more conducive to the detection and diagnosis of diabetes.
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