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Objective To evaluate the sensitivity and specificity of different HbA1C cutoff points for diabetes diagnosis in high risk outpatients in Harbin.Methods A total of 2 122 high risk outpatients(male 1 032 and female 1 090)for diabetes screening in the Fourth affiliated Hospital of Harbin Medical University from April 2013 to February 2015 were included in this study, with the average age of(49.26±13.00)year. Oral glucose tolerance tests(OGTT)were conducted and HbA1C levels were examined in these patients. The sensitivity and specificity of different HbA1C cutoff points were calculated and a receiver operator characteristic(ROC)curve was then built.Results The average level of HbA1C in these subjects was(6.45±1.72)%. The prevalence of diabetes was 41.85%. The area under ROC curve(AUC)was 0.89 with the optimal cutoff point of HbA1C 6.0% and 0.68 for the highest Yonden index. The sensitivity and specificity of HbA1C 6.0% were 84.01% and 83.67% respectively. The sensitivity and specificity of HbA1C 6.5% were 62.84% and 95.92%, respectively. The AUC of HbA1C≥6.5% was 0.732. Conclusion HbA1C works well as the diagnostic standard for diabetes in high risk outpatients of Harbin city. The cutoff point of HbA1C 6.0% is suitable for screening diabetes in high risk population, and HbA1C 6.5% is appropriate for diabetes diagnosis, with high sensitivity and specificity.
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Objective To measure the vitamin B1 levels in plasma,erythrocytes and urine of the patients with type 2 diabetes,and to analyze the correlation of vitamin B1 level with the progression of diabetic nephropathy,and to clarify the metabolism of nutrtion mechanism of type 2 diabetic nephropathy.Methods Total 90 patients with type 2 diabetes and 30 healthy volunteers were recruited.According to the levels of microalbuminuria,the patients with type 2 diabetes were divided into non diabetic nephropathy (NDN)group,early diabetic nephropathy (EDN)group and clinical diabetic nephropathy (CDN)group (n=30);the healthy people was used as normal control (NC) group.The vitamin B1 levels in the plasma,erythrocytes and urine were examined with high performance liquid chromatography (HPLC). The correlation of microalbuminuria with the plasma viamin B1 level was analyzed. Results The level of vitamin B1 in plasma of the patients in NC group was (7.1±3.3)μg·L-1,while it was (4.0±2.3)μg·L-1 in NDN group,(3.1±1.0)μg·L-1 in EDN group and (2.3±0.6)μg·L-1 in CDN group. Compared with NC group,the vitamin B1 levels in the plasma in NDN,EDN and CDN groups dropped 43.7%, 56.3%,and 67.6%,respectively (P<0.05). The excretion of vitamin B1 in urine were (2.9 ± 0.8),(9.0 ± 4.7),(11.7±3.9),and (15.6±5.0)μg·L-1 in NC group,NDN group,EDN group and CDN group, respectively.Compared with NC group,the vitamin B1 levels in the urine in NDN,EDN and CDN groups were increased by 2,3 and 4 times,respectively (P<0.05).A negative correlation was found between the level of microalbuminuria and the level of vitamin B1 in plasma (r=-0.62,P=0.013).Conclusion Vitamin B1 deficiency can be observed in the early stage of diabetic nephropathy,and the level of vitamin B1 is closely correlated with the progression of diabetic nephropathy.