口腔医学研究

口腔医学研究 ›› 2017, Vol. 33 ›› Issue (8): 856-859.DOI: 10.13701/j.cnki.kqyxyj.2017.08.014

• 临床研究论著 • 上一篇    下一篇

龈沟血糖化血红蛋白筛查糖尿病的应用研究

吴娟1, 赵洁1, 张璇1, 孙卫斌1, 林月2, 林良缘3*   

  1. 1. 南京大学医学院附属口腔医院,南京市口腔医院牙周科 江苏 南京 210008;
    2. 江苏省苏北人民医院医学检验科 江苏 南京 225001;
    3. 南京医科大学附属儿童医院口腔科 江苏 南京 210029
  • 收稿日期:2016-12-29 出版日期:2017-08-20 发布日期:2017-08-28
  • 通讯作者: 林良缘,E-mail:120262030@qq.com
  • 作者简介:吴娟(1982~ ),女,江苏人,主治医师,硕士,主要从事牙周病与系统性疾病相关性研究。
  • 基金资助:
    国家自然科学基金(编号:51472115);南京市医学科技发展项目(编号:YKK15165)

HemoglobinA1c in Gingival Crevicular Blood Screening for Diabetes

WU Juan1, ZHAO Jie1, ZHANG Xuan1, SUN Wei-bin1, LIN Yue3, LIN Liang-yuan3*   

  1. 1. Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China;
    2. Clinical Medical Examination Center, Northern of Jiangsu People'
    s Hospital, Nanjing 225001, China;
    3. Children'
    s Hospital Affiliated to Nanjing Medical University Department of Stomatology, Nanjing 210029, China.
  • Received:2016-12-29 Online:2017-08-20 Published:2017-08-28

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摘要： 目的:评估在牙周探诊中获得的龈沟血(gingival crevicular blood,GCB)的糖化血红蛋白(HbAlc)是否可以代替手指末梢血(finger stick capillary blood,FSB)来筛查糖尿病(diabetes mellitus,DM)的可靠性,为DM筛查提供新渠道。方法:选取中重度慢性牙周炎患者,血糖仪检测GCB和FSB的血糖,Bio-rad D10全自动糖化血红蛋白分析仪检测GCB和FSB的HbAlc,Pearson相关系数分析GCB和FSB血糖以及HbAlc的相关性,受试者工作特征( receiver operating characteristic,ROC)曲线确定GCB HbAlc对DM的最佳诊断界值。结果:本研究收集了60例中重度慢性牙周炎患者,根据有无DM史、FSB血糖以及HbAlc的结果,发现18例有DM、42例无DM的牙周炎患者,两组GCB和FSB血糖的相关性分别为r=0.993和r=0.926;HbAlc的相关性分别为r=0.977和r=0.829;ROC曲线确定GCB HbAlc对DM的最佳诊断界值为HbAlc=5.7%,灵敏度为100%,特异度为95.2%。结论:与FSB HbA1c相比,牙周探诊获得的GCB进行HbA1c检测同样准确,最佳诊断界值为GCB HbAlc=5.7%,可能用于筛查DM患者。

关键词: 牙周炎, 糖尿病, 龈沟血, 糖化血红蛋白

Abstract: Objective: To determine if hemoglobinA1c (HbA1c) gingival crevicular blood (GCB) could be used to build a predictive model for diabetes. Methods: Patients were divided into two groups based on the history of diabetes and the results of HbAlc in finger-stick blood (FSB). Group 1 was diabetes and Group 2 was without diabetes. FSB and GCB were collected from moderate or severe periodontitis patients with adequate bleeding on probing. Glucose and HbA1c levels were analyzed. The Pearson correlation coefficient was used to measure the correlation between glucose and HbA1c values in FSB and GCB. A receiver operator characteristic (ROC) curve analysis was performed to determine an optimal GCB HbA1c criterion value for a positive diabetes screening. Results: The pearson correlation coefficients were 0.993 and 0.926 for FSB and GCB glucose, respectively, and were 0.977 and 0.829 for FSB and GCB HbA1c. The ROC analysis identified a criterion value of 5.7% for the GCB HbA1c test with high sensitivity (100%) and high specificity (95.2%), corresponding to FSB HbA1c values ≥ 6.5% (in the diabetes range). Conclusion: HbA1c in GCB samples may be an acceptable predictor for diabetes screening.

Key words: Periodontitis , Diabetes , Gingival crevicular blood , HbAlc

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