基于血红蛋白1c筛查前驱糖尿病和糖尿病:克罗地亚成年人的多中心研究

IF 3.8 3区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Biochemia Medica Pub Date : 2022-02-15 Epub Date: 2021-12-15 DOI:10.11613/BM.2022.010903
Ivana Lapić, Dunja Rogić, Nora Nikolac Gabaj, Katarina Kajić, Nena Peran, Lada Surjan, Anamarija Đuras, Valentina Cesar Kocijan, Nada Bilopavlović, Fran Smaić, Mario Štefanović, Ivanka Ostroški, Leida Tandara, Milena Krnjaić-Tadijanović, Ivan Gornik, Hrvoje Pintarić, Daniela Marasović Krstulović, Blaženka Miškić, Dario Rahelić
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引用次数: 3

摘要

引言:基于有相当比例的成年人患有前驱糖尿病和未确诊糖尿病(DM)的假设,我们的目的是在克罗地亚成年人队列中进行基于血红蛋白A1c (HbA1c)的筛查,并根据美国糖尿病协会的标准估计前驱糖尿病和未确诊糖尿病的患病率。材料和方法:这项多中心、横断面研究在克罗地亚6家医院进行,包括5527名年龄在40至70岁之间的患者,他们被急诊室收治或接受初级保健检查。用酶法在Alinity c或Architect c系列分析仪(Abbott Laboratories, Chicago, USA)上检测剩余全血样本的血红蛋白A1c。血红蛋白A1c在39-47 mmol/mol之间被归类为前驱糖尿病,而≥48 mmol/mol被归类为未确诊的DM。结果:在排除了435例已知DM患者后,最终队列包括5092例患者(中位年龄57;56%的男性)。共有882例(17.3%)患者的HbA1c值在39 - 47 mmol/mol之间。HbA1c≥48 mmol/mol的患者214例(4.2%)。糖尿病前期患病率为14.2% ~ 20.5%,未确诊糖尿病患病率为3.3% ~ 7.3%,各设置间差异有统计学意义(P < 0.001)。年龄分层分析显示,糖尿病前期和未确诊的糖尿病患病率随年龄增加(P < 0.001),在60 ~ 70岁的患者中分别为25.4%和5.8%。结论:在大约五分之一的成年人中发现了潜在的糖代谢障碍,其中有相当数量的患者已经患有显性糖尿病。这些结果应该作为克罗地亚进一步促进糖尿病预防措施的起点。
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Haemoglobin A1c-based screening for prediabetes and diabetes mellitus: a multi-center study in Croatian adult population.

Introduction: Based on the hypothesis that there is a substantial rate of adults with prediabetes and undiagnosed diabetes mellitus (DM), our aim was to perform haemoglobin A1c (HbA1c)-based screening in a cohort of Croatian adults and estimate the prevalence of prediabetes and undiagnosed DM according to American Diabetes Association criteria.

Materials and methods: This multi-center, cross-sectional study performed in six Croatian hospitals included 5527 patients aged 40 to 70 years admitted to the Emergency Department or undergoing a primary care check-up. Haemoglobin A1c was measured from leftover whole blood samples using the enzymatic method on either Alinity c or Architect c-series analyser (Abbott Laboratories, Chicago, USA). Haemoglobin A1c between 39-47 mmol/mol was classified as prediabetes, while ≥ 48 mmol/mol as undiagnosed DM.

Results: After exclusion of 435 patients with known DM, the final cohort included 5092 patients (median age 57; 56% males). A total of 882 (17.3%) patients had HbA1c values between 39 and 47 mmol/mol. There were 214 (4.2%) patients with HbA1c ≥ 48 mmol/mol. Prediabetes prevalence ranged from 14.2% to 20.5%, while undiagnosed DM from 3.3% to 7.3%, with statistically significant differences among settings (P < 0.001). Age-stratified analysis showed that prediabetes and undiagnosed DM prevalence increase with age (P < 0.001), being 25.4% and 5.8%, respectively, in patients aged 60 to 70 years.

Conclusion: Underlying impairment of glucose metabolism was identified in about one in five adults, with significant number of patients with already overt DM. These results should serve as a starting point for further steps directed towards promotion of preventive measures for DM in Croatia.

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来源期刊
Biochemia Medica
Biochemia Medica 医学-医学实验技术
CiteScore
5.50
自引率
3.00%
发文量
70
审稿时长
>12 weeks
期刊介绍: Biochemia Medica is the official peer-reviewed journal of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Journal provides a wide coverage of research in all aspects of clinical chemistry and laboratory medicine. Following categories fit into the scope of the Journal: general clinical chemistry, haematology and haemostasis, molecular diagnostics and endocrinology. Development, validation and verification of analytical techniques and methods applicable to clinical chemistry and laboratory medicine are welcome as well as studies dealing with laboratory organization, automation and quality control. Journal publishes on a regular basis educative preanalytical case reports (Preanalytical mysteries), articles dealing with applied biostatistics (Lessons in biostatistics) and research integrity (Research integrity corner).
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