不同糖代谢状态人群糖化血清白蛋白与HbA1c的相关性分析  

Defining the relationship between glycated albumin and HBA1c in individuals with a diverse spectrum of glucose metabolism

作　　者：马晓静[1] 包玉倩[1] 周健[1] 唐峻岭[1] 胡承[1] 吴松华[1] 项坤三[1] 贾伟平[1] 

机构地区：[1]上海市糖尿病临床医学中心,上海市糖尿病研究所,上海交通大学附属第六人民医院内分泌代谢科,200233

出　　处：《中华内分泌代谢杂志》2010年第6期452-455,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：上海市市级医院新兴前沿技术联合攻关项目（SHDC12006101）;上海市糖尿病重点实验室项目（08DZ2230200）

摘　　要：目的 探讨糖化血清白蛋白（GA）与HbA1c的关系,并初步建立不同HbA1c水平其相对应的GA值.方法 选取2006年10月至2009年4月来上海交通大学附属第六人民医院门诊进行口服葡萄糖耐量试验（OGTT）的受试者2 532名,其中正常糖调节组898例、糖调节受损组695例、新诊断2型糖尿病患者组939例.采用液态酶法测定GA水平,高压液相法测定HbA1c水平,分析GA与HbA1c之间的关系.结果 （1）2532例研究对象,HbA1c水平为（6.3±1.1）%,GA水平为（17.9±4.5）%,GA/HbA1c为2.85±0.51.（2）HbA1c、GA及空腹血糖、糖负荷后各时点血糖均显著正相关（r为0.567～0.776,P均〈0.01）.（3）GA与HbA1c呈显著正相关（r=0.701,P〈0.01）,其回归方程为GA=2.871×HbA1c-0.112,即HbA1c每升高1%,GA相应升高2.87%.HbA1c为6.5%时,对应的GA值为18.5%;以GA≤18.5%来预测HbA1c≤6.5%,其敏感性、特异性、阳性预测值、阴性预测值、准确度分别为82.32%、72.49%、86.48%、65.73%、79.19%.而当HbA1c为7.0%时,GA对应值为20.0%;当HbA1c7.5%时,GA对应值为21.4%.结论 初步建立了各Hbh1c水平其相应的GA值,为GA的临床应用提供了依据.ObjeclJve To definine the corresponding value to glycated albumin（GA）for a specific target of HbAlc,and to elvaluate the relationship between GA and HbA1c.Methods From Oct.2006 TO Apr.2009, 2 532 subjects were enrolled who accepted oral glucose tolerance test（OGtt）in out-patient department,including 898 with normal glucose regulation,695 with impaired glucose regulation,and 939 with newly-diagnosed diabetes.GA was measured with liquid enzymatic method.HbA1c was measured with high performance liquid chromatography method.The plasma glucose was measured at fasting,0.5 h,1 h,2 h,and 3h after glucose load.The correlation among GA,HbA1c and the other parameters monitored was analyzed.Results （1）The levels of HbA1c and GA in 2 532 subjects were（6.3±1.1）% and（17.9±4.5）%.The ratio of GA/HbA1c was 2.85±0.51.（2）HbAlc and GA were positively correlated with fasting,0.5 h,1 h,2 h and 3 h plasma glucose（r was in 0.567-0.776,atl P〈0.01）.（3）GA was significantly correlated with HbA1c（r=0.701,P〈0.01）.Linear regression analysis,using GA and HbA1c summarized by patient（n=2 532）,produced a relationship of GA=2.871×HbA1c-0.112.The change in GA per increase of 1% HbA1c was 2.87%.When HbA1c level was 6.5%,the expected value of GA was 18.5%.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy with GA≤18.5% to predict HbA1c≤6.5% were 82.32%,72.49%,86.48%.65.73%,and 79.19%,respectively.When HbA1c level was 7.0%,the expected value of GA was 20.O%.When HbA1c level was 7.5%.the expected value of GA was 21.4%.Conclusions We initially establish the corresponding value to GA for a specific target of HbA1c and provide the basis for clinical application.

关 键 词：糖尿病 2型 糖化血清白蛋白 HBA1C 

分 类 号：R587.1[医药卫生—内分泌]