论文部分内容阅读
[目的]探讨正常糖耐量(NGT)伴胰岛素抵抗(IR)人群中2型糖尿病高危人群的判别方法.[方法]对204例NGT受试者进行(6.01±0.35)年的随访研究,以随访时是否发展为前驱糖尿病和或2型糖尿病为标准,分析基线时受试者空腹胰岛素(Fins)、胰岛素曲线下面积(AUCins)、稳态模型胰岛素抵抗指数(HOMA-IR)、稳态模型胰岛β细胞分泌(HOMA-β)及胰岛素早期分泌指数(ΔI30/ΔG30)等指标的受试者工作特征(ROC)曲线下面积,选择最大ROC曲线下面积为指标,以该指标约登指数最大分值为最佳诊断临界值,根据其将基线时204例NGT受试者分为高危组和低危组,比较两组基线时IR情况及随访时前驱糖尿病和或2型糖尿病的发病率.[结果]Fins,AUCins,HOMA-IR,HOMA-β和ΔI30/ΔG30等指标的ROC曲线下面积分别为0.805,0.848,0.825,0.632和0.753,以AUCins的ROC曲线下面积为最大,其最佳诊断临界值为108.43 mU/L.与低危组比较,高危组前驱糖尿病或2型糖尿病发病率显著增高(29.41%,2.21%,P<0.001),Fins,AUCins,HOMA-IR等指标亦均显著增高(P<0.001).[结论]2型糖尿病高危人群也存在于NGT受试者中.以AUCins≥108.43 mU/L为诊断临界值可初步筛查2型糖尿病的高危人群.
[Objective] To investigate the discriminant method of high-risk type 2 diabetes in normal glucose tolerance (NGT) patients with insulin resistance (IR). [Methods] The follow-up study of 6.0 NGT subjects (6.01 ± 0.35) (AUCins), homeostasis model insulin resistance index (HOMA-IR), homeostasis model islet (HOMA-β) and early insulin secretion index (ΔI30 / ΔG30) and other indicators of the receiver operating characteristic (ROC) area under the curve, choose the area under the maximum ROC curve as an index to the index Youtun Index maximum score Values for the best diagnostic threshold, according to its baseline 204 cases of NGT subjects were divided into high-risk group and low-risk group at baseline baseline IR and the incidence of pre-diabetes or type 2 diabetes at the time of follow-up [ Results The area under the ROC curve of Fins, AUCins, HOMA-IR, HOMA-β and ΔI30 / ΔG30 were 0.805, 0.848, 0.825, 0.632 and 0.753, respectively. The area under the ROC curve of AUCins was the best. The critical value was 108.43 mU / L. Compared with the low-risk group, the high-risk group was the precursor The incidence of diabetes mellitus or type 2 diabetes mellitus was significantly higher (29.41%, 2.21%, P <0.001), and the indexes of Fins, AUCins and HOMA-IR were significantly higher (P <0.001). [Conclusion] Existed in NGT subjects.Using AUCins≥108.43 mU / L as the diagnostic threshold, we could initially screen the high risk population of type 2 diabetes mellitus.