高海拔居住史对检测葡萄糖代谢异常的最佳 HbA1c 临界值的影响

IF 1.6 4区 医学 Q4 BIOPHYSICS
Zengmei Sun, Suyuan Wang, Hua He, Chenghui Zhang, Mingxia Li, Yan Ye, Huiqin Zhang, Xuanyu Yao, Shuyao Sun, Yuanze Du, Yang Zhong, Yunhong Wu
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引用次数: 0

摘要

目的:探讨近期高海拔居住史对检测糖代谢异常的糖化血红蛋白(HbA1c)最佳临界值的影响。研究方法该研究在成都招募了 505 名 18-65 岁自报健康的汉族参与者,并根据最近(3 个月内)的高海拔(大于 2500 米)居住史进行分类。1999年世界卫生组织的标准是界定糖尿病前期和糖尿病的金标准。HbA1c 测试结果采用接收者操作特征曲线进行评估,并根据最大尤登指数(Maximum Youden index)确定最佳临界值。使用 0.02 卡尺和近邻法进行倾向评分匹配,以平衡组间混杂因素。研究结果在参与者中,238 人(47.13%)为近期高海拔居住史人群(HA 组),267 人(52.87%)为低海拔居住者(LA 组)。与 LA 组相比,HA 组的 HbA1c 水平略高(P > 0.05),红细胞和血红蛋白水平较高(P < 0.05)。在 HA 组(rs = 0.21,p < 0.05)和 LA 组(rs = 0.07,p = 0.25)观察到糖尿病前期与 HbA1c 水平之间存在弱相关性。HA 组检测糖尿病的最佳临界值为 6.5%(曲线下面积 [AUC] 0.94),LA 组为 5.9%(曲线下面积 [AUC] 0.97)。结论与生活在低海拔地区的普通人群相比,近期有高海拔地区生活史的人群中检测糖尿病的最佳 HbA1c 临界值更高,而且 HbA1c 对糖尿病前期的诊断价值也不足。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Influence of High-Altitude Residential History on Optimal HbA1c Cutoff for Detecting Abnormal Glucose Metabolism.

Aims: To explore the influence of recent high-altitude residential history on the optimal cutoff of glycosylated hemoglobin (HbA1c) for detecting abnormal glucose metabolism. Methods: The study included 505 self-reported healthy Han participants of age 18-65 years, recruited in Chengdu and categorized based on recent (within 3 months) high-altitude (>2,500 m) residential history. The 1999 WHO criteria was used as the gold standard for defining prediabetes and diabetes. HbA1c test performance was assessed using receiver operating characteristic curve, with the optimal cutoff determined by Maximum Youden index. Propensity score matching with 0.02 calipers and nearest neighbor method was used to balance confounding factors between groups. Results: Of the participants, 238 (47.13%) were populations with recent high-altitude residential history (HA group), and 267 (52.87%) were low-altitude dwellers (LA group). The HA group had slightly higher HbA1c levels (p > 0.05) and higher erythrocyte and hemoglobin levels (p < 0.05), compared to the LA group. Weak correlations between prediabetes and HbA1c levels were observed in the HA group (rs = 0.21, p < 0.05) and the LA group (rs = 0.07, p = 0.25). The optimal cutoff for the detection of diabetes was 6.5% (area under the curve [AUC] 0.94) in the HA group and 5.9% (AUC 0.97) in the LA group, which remained unchanged after adjustment for confounders. Conclusions: The optimal cutoff of HbA1c for the detection of diabetes in populations with recent history of living at high altitude was higher than that in general populations living at low altitude, and the diagnostic value of HbA1c for prediabetes was also inadequate.

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来源期刊
High altitude medicine & biology
High altitude medicine & biology 医学-公共卫生、环境卫生与职业卫生
CiteScore
3.80
自引率
9.50%
发文量
44
审稿时长
>12 weeks
期刊介绍: High Altitude Medicine & Biology is the only peer-reviewed journal covering the medical and biological issues that impact human life at high altitudes. The Journal delivers critical findings on the impact of high altitude on lung and heart disease, appetite and weight loss, pulmonary and cerebral edema, hypertension, dehydration, infertility, and other diseases. It covers the full spectrum of high altitude life sciences from pathology to human and animal ecology.
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