| 0bjective To evaluate value of glycated hemoglobin (HbAlc) on the diagnosis of diabetes and related factors.Methods 841 subjects(Male 482, female 359) in order to clarify the diagnosis of diabetes in the first affiliated hospital of Fujian Medical University between April 2009 and September 2010, underwent an oral 75 g glucose tolerance test (OGTT). HbA1c was measured at the same time. Their average age was 56.9±14.2 years. Receiver operating characteristic curve (Roc curve) was used to look for the optimal cut points of HbAlc related to diabetes diagnosed by OGTT. Analysis of variance was used to determine whether there were differences of levels of HbA1c among groups of normal glucose tolerance, impaired glucose regulation and diabetes mellitus. Correlation analysis and multiple regression analysis were used to search factors of glycated hemoglobin.Results The average age of 841 cases studied was 56.9±14.2 years, male 57.3%. According to fasting plasma glucose and postprandial blood glucose levels of the 1999 WHO diagnostic criteria for diabetes, the optimal cut point of HbA1c as a diagnostic criteria for diabetes was 6.45%, sensitivity 58.7%, specificity 86.5%. HbA1c was higher in diabetic patients whose fasting and postprandial blood glucose were both high, than diabetic patients whose fasting blood glucose was high or postprandial blood glucose was high. The related factors of HbA1c include gender, high blood pressure, fasting glucose, postprandial blood glucose, HomaB, HDL, LDL, TG, HGB. Multiple regression analysis showed that the most important factors of HbA1c were fasting and postprandial blood glucose, islet cell function, insulin resistance. Conclusion The optimal cut point of HbA1c as a diagnostic criteria for diabetes was 6.45%, the sensitivity is a bit weak, but specificity better. When levels of glycosylated hemoglobin is high, the factors such as insulin resistance, should be fully considered. |
