摘要目的 探讨口服葡萄糖耐量试验(OGTT)中1h血糖在T2DM和IGR诊断中的切点值和临床价值.方法 354例(6.0mmol/L≤FPG ＜7.0mmol/L)受试者行OGTT,应用接受者工作特征(ROC)曲线分析1hPG诊断IGR和T2DM的切点值,并与WHO诊断标准进行比较.结果 (1)由ROC曲线得出筛查T2DM的切点值为12.90mmol/L,特异性77.1％,敏感性90％;筛查IGR的切点值10.83mmoL/L,特异性73.2％,敏感性73.5％.(2)在WHO标准诊断的T2DM 136例中,1hPG诊断115例,高于FPG诊断的81例(P＜0.005),也高于2h PG诊断的106例,但差异无统计学意义(P＞0.05);以2h PG≥11.1mmol/L诊断T2DM 106例中,1hPG诊断95例,高于FPG诊断的51例(P＜0.01).(3)应用1hPG切点对NGT、IFG、IGT、CGI和DM重新分组后,各亚组FPG、2hPG(如NGT组亚组1 h-NGT-NGT-1 h-NGT-IGR-1 h-NGT-DM)的顺序逐渐升高.(4)1hPG和2hPG不论血糖高低均有良好的相关性(P =0.000),FPG只在血糖高时与2hPG相关;1hPG和FPG只在血糖正常时相关性消失.结论1 hPG切点12.90mmol/L诊断2型糖尿病具有优势,是WHO标准的有益补充.

abstractsObjective To investigate the cut-off point value of 1-hour plasma glucose of oral glucose tolerance test in the diagnosis of the T2DM and IGR.Methods Three hundred and fifty-four subjects (6.0mmol/L≤ FPG ＜ 7.0mmol/L) were participated in the OGTT.To get the cut-off point value of 1-hour plasma glucose in the diagnosis of the T2DM and IGR by applying the receiver operator characteristic curve,and compare it with the WHO diagnostic criteria.Results (1)The cut-off point value of screening T2DM by ROC curve was 12.90mmol / L,whose specificity was 77.1％ and sensitivity was 90％.Meanwhile the cut-off point value of screening IGR was 10.83mmol / L,whose specificity was 73.2％,and the sensitivity was 73.5％.(2)Among the 136 patients with type 2 diabetes mellitus that diagnosed by WHO criteria,115 patients could be diagnosed by 1hPG that more than FPG which could diagnose 81 patients.And the difference was statistically significant (P ＜ 0.05).Meanwhile,It was more than 106 patients that diagnosed by 2hPG,but there was no statistically significant.According to the diagnostic criteria of 2hPG ≥11.1mmol/L,there were 106 cases of T2DM.Among these patients,95 cases and 51 cases could be diagnosed respectively by 1 hPG and FPG,and there was statistically significant (P ＜ 0.01).(3)Application of the cut-off point of 1 hPG,NGT,IFG,CGI and DM re-grouped.FPG,2hPG increased gradually in order to NGT,IGR,DM.(4) No matter the blood glucose levels,1hPG and 2hPG had good correlation,(P =0.000).A significant correlation could be found between FPG and 2hPG only in hyperglycemia.The correlations between 1 hPG and FPG disappeared only in a normal level of blood glucose.Conclusion The cutoff point value of 1hPG is 12.90mmol/L which has advantage to diagnosis of type 2 diabetes mellitus.It is a useful complement to the WHO Diagnostic criteria.