2型糖尿病患者糖化血红蛋白与血脂联合检测的临床意义

摘要

目的：探讨糖化血红蛋白（HbA1c）、血脂检测对2型糖尿病（T2DM）的诊断价值。方法选取本院门诊体检疑似T2DM患者218例作为研究对象，所有患者均行口服葡萄糖耐量试验（OGTT），根据2008年美国糖尿病学会（ADA）诊断标准分为糖耐量正常组（NGT）28例、糖调节受损（IGR）组66例，T2DM组124例，并测定三组患者空腹血糖（FPG）、餐后2小时血糖（2hPG）、HbA1c、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）水平。结果①HbA1c、FPG、2hPG、TC、TG和LDL-C水平在NGT组、IGR组和T2DM组逐渐升高，三组比较差异具有显著性（P＜0.05）；②当HbA1c≥6.1%时，诊断糖尿病的灵敏度和特异度之和最大；③Spearman相关分析显示，HbA1c与FPG（r＝0.732，P＜0.05）及2hPG呈正相关（r＝0.583，P＜0.05）。T2DM组患者HbA1c与FPG（r＝0.376，P＜0.05）、2hPG（r＝0.572，P＜0.05）、TC（r＝0.372，P＜0.05）、TG（r＝0.373，P＜0.05）、LDL-C（r＝0.366，P＜0.05）均呈正相关。NGT组及IGR组患者HbA1c水平与上述指标无明显相关性。结论 T2DM患者HbA1c、血脂水平均明显升高，与血糖水平相关，通过对患者HbA1c和血脂水平的检测可为T2DM的诊断和防治提供参考依据。%Objective To investigate the diagonostic value signiifcance of HbA1c and blood lipid inspection in type 2 diabetic (T2DM) patients. Method 218 cases suspected as T2DM patients were selected, all patients underwent an oral glucose tolerance test (OGTT) in accordance to the diagnostic criteria of ADA 2008 divided into groups with normal glucose tolerance (NGT) of 28 cases, impaired glucose regulation (IGR) of 66 cases, type 2 diabetes mellitus (T2DM) of 124 cases. The fasting blood glucose (FPG), 2 hours postprandial plasma glucose (2hPG), HbA1c, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured of all three group patients. Result ①HbA1c, FPG, 2hPG, TC, TG and LDL-C levels in NGT group , IGR group and T2DM group gradually increased, three groups had signiifcant differences (P<0.05); ②HbA1c≥6.1%, which had the largest sensitivity and speciifcity in diagnosis of diabetes;③Spearman correlation analysis showed that HbA1c and FPG (r=0.732, P<0.05) and 2hPG were positively correlated (r=0.583, P<0.05). FPG (r=0.376, P<0.05), 2hPG (r=0.572, P<0.05), TC (r=0.372, P<0.05), TG (r=0.373, P<0.05) and LDL-C (r=0.366, P<0.05) were positively related to HbA1c in T2DM group. There was no correlation in NGT group and IGR group. Conclusion T2DM patients with HbA1c, lipid levels were significantly increased, associated with blood sugar levels, through the detection of patients with HbA1c and lipid levels can provide a reference for the diagnosis and prevention of T2DM.