ObjectiveTo analyze the glycated hemoglobin A1c (HbA1c) level among healthy adults in Quanzhou area and explore distribution of HbA1c concentration by age and gender, and establish relevant reference range. MethodsUnder the standardized test of HbA1c, HbA1c concentrations of 1 931 healthy adults were determined by HLC-723 G8 HbA1c analyzer (TOSOH corp, Japan) and its agents. HbA1c levels of different age (18-30, 31-40, 41-50, 51-60, >60) and gender groups were compared, percentile was adopted to establish the corresponding HbA1c reference range of healthy adults in Quanzhou area according to "WS/T402-12-2012. Define and Determine the Reference Interval in Clinical Laboratory" and CLSI C28-A3. ResultsThe total HbA1c levels among healthy adults in Quanzhou area were 3.8%-6.4% (5.31%±0.40%), and the total HbA1c levels among male and female healthy adults in Quanzhou area were 5.55%±0.36% and 5.47%±0.43%, respectively, HbA1c concentration between different gender were statistically significant (P≤0.01). Compared in HbA1c levels of different age (18-30, 31-40, 41-50, 51-60, >60) and gender groups: the difference of HbA1c concentration between different gender in 18-30 years and 31-40 years group was statistically significant (P<0.05) and on the contrary the remaining three age groups were no statistically significant. Compared in HbA1c levels of different age groups in male: the difference of HbA1c concentration between different age groups in 31-40 years and 41-50 years group were no statistically significant (P>0.05), but statistically significant (P<0.05) in the remaining three age groups. The difference of HbA1c concentration between different age groups in female were statistically significant (all P values ≤0.01). The reference intervals of HbA1c for males and females were 4.8%-6.2% and 4.6%-6.3%, respectively, with statistically significant (P=0.000); the reference intervals of HbA1c according to age and gender were: for 18-30 years in males and females were 4.6%-6.0% and 4.4%-6.0%, respectively, with statistically significant (P≤0.01); for 31-40 years in males and females were 4.7%-6.0% and 4.7%-6.2%, respectively, with statistically significant (P≤0.01); for 41-50 years, 51-60 years, >60 years in males and females were no statistically significant (P>0.05), the reference intervals were 4.8%-6.2%, 4.8%-6.4%, and 5.1%-6.4%, respectively. Compared in HbA1c reference intervals in this paper with ADA and Chinese Clinical Operating Program, the difference were statistically significant (P=0.000). ConclusionUnder the standardized test of HbA1c, HbA1c concentrations of age and gender groups of 1 931 healthy adults in Quanzhou area are partial different, the reference interval of HbA1c of age and gender groups for healthy adults in Quanzhou area are established.
Based on literatures on Meta-analysis and randomized controlled trial, drug use and some geriatrics syndromes such as cognitive impairment and depression, in elderly diabetic patients were reviewed. Insulin plus oral hypoglycemic drugs was more rational therapy for insulin resistance and islet dysfunction in type 2 diabetes mellitus. We should pay more attention to cognitive impairment and depression in elderly type 2 diabetic patients.
ObjectiveTo systematically review the diagnosis value of glycosylated hemoglobin (HbA1c) in diagnosis of gestational diabetes mellitus (GDM).MethodsThe diagnostic studies concerning glycosylated hemoglobin in gestational diabetes were electronically searched in EMbase, PubMed, The Cochrane Library, CNKI, WanFang Data and VIP from inception to October, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by QUADAS-2 standard. Meta-analysis was performed by RevMan 5.3 and Meta-Disc 1.4 software.ResultsA total of 33 studies involving 16 622 persons were included. The results of meta-analysis showed that the pooled sensitivity, specificity, positive predictive value, negative predictive value, the pooled DOR of HbA1c were 0.75 (95%CI 0.74 to 0.77), 0.91 (95%CI 0.90 to 0.91), 8.21 (95%CI 5.41 to 12.46), 0.18 (95%CI 0.11 to 0.28), 45.10 (95%CI 29.70 to 68.48), respectively. The AUC of SROC was 0.933 5. Subgroup analysis by different HbA1c measurements indicated that little variations between different measurements in sensitivity and specificity.ConclusionHbA1c in GDM diagnosis has high sensitivity and specificity. Due to the limited quality and quantity of included studies, the above results should be validated by more studies.