Clinical Study On Screening Diabetes Mellitus With Fasting Blood Glucose And Glycosyated Hemoglobin

ObjectiveThe purpose of this study is to find out the cut-off value of glycosylated hemoglobin(Hb A1c)and fasting plasma glucose(FPG)suitable for screening diabetes mellitus in Northwest Shaanxi by screening high-risk population of diabetes mellitus in Shaanxi,and to provide multi-point data for the diagnosis of glycosylated hemoglobin in China,so as to find a simpler,more accurate and more effective method for screening diabetes mellitus and impaired glucose regulation in the future.Methods To reduce the missed diagnosis and misdiagnosis of diabetes and impaired glucose regulation,do a good job of primary prevention of diabetes,improve their quality of life,and reduce the waste of medical resources.MethodA retrospective study was conducted on 667 patients who underwent diabetes diagnostic tests in a third-class A hospital in Baoji City,Shaanxi Province from January2013 to December 2018.667 patients received fasting plasma glucose,glycosylated hemoglobin and 75 g oral glucose tolerance test at the same time.Statistical analysis was carried out for data input,t test and regression analysis were carried out,ROC curve and PR curve were drawn,and screening and diagnosis of fasting plasma glucose and glycosylated hemoglobin were studied respectively when oral glucose tolerance test was used as the gold standard for diagno-sing fasting plasma glucose and glycosylated hemoglobin.The cut-off points of diabetes mellitus and impaired glucose regulation.Result1.Gender is correlated with fasting plasma glucose,body mass index is positively correlated with fasting plasma glucose;hypertension,hyperlipidemia,age and body mass index are positively correlated with oral glucose tolerance test;gender is correlated with glycosylated hemoglobin,hyperlipidemia,family history,age and body mass index are positively correlated with glycosylated hemoglobin.2.Logistic regression analysis showed that the higher the fasting plasma glucose and glycosylated hemoglobin,the higher the risk of diabetes mellitus.The combination of the two methods was C=1.158*FPG+0.688*Hb A1 c.The higher the combined index,the higher the risk of diabetes mellitus.3.The cut-point value of fasting plasma glucose for screening and diagnosing diabetes mellitus was 5.64 mmol/L.The overall accuracy rate was 54.27%,TPR 95%,FPR 62.98%,and area under curve 0.834.The cut-point value of glycosylated hemoglobin for screening and diagnosing diabetes mellitus was 5.30%,the overall accuracy rate was 45.73%,TPR95%,FPR 74.89%,and area under curve 0.813.Taking the joint index C equal to 10.407 as the demarcation value,the overall accuracy rate was 55.17%,TPR 95%,FPR 61.49%,and the area under the curve 0.851.ConclusionIn this study,the cut-off values of fasting plasma glucose and glycosylated hemoglobin screening for diabetes mellitus were 5.64 mmol/L and 5.30% respectively.Through the comparative analysis of ROC curves,it was found that the combined index was better than any single index for the diagnosis of diabetes mellitus screening.The combined index of fasting plasma glucose and glycosylated hemoglobin was recommended as the basis for the screening and diagnosis of diabetes mellitus patients.When abdominal blood sugar(> 5.64 mmol/L)and glycosylated hemoglobin(> 5.30%),the possibility of diabetes mellitus should be considered and oral glucose tolerance test should be conducted to determine the diagnosis.