1，5-脱水葡萄糖醇：可能是更好反映短期血糖控制水平的标志  

1,5-anhydroglucitol： a better marker for short-term glycemic control

作　　者：孙杰[1,2] 窦京涛[1] 杨国庆[1] 吕朝晖[1] 母义明[1] 郑华[1] 马芳玲[1] 陆菊明[1] 

机构地区：[1]解放军总医院内分泌科,北京100853 [2]解放军第八十九医院内分泌科

出　　处：《中华糖尿病杂志》2012年第4期212-215,共4页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的初步建立1，5-脱水葡萄糖醇（1，5-AG）在健康人群中的参考范围，并探讨1，5-AG与短期血糖控制水平的相关性。方法2010年3至7月在北京古城和苹果园社区及解放军总医院门诊体检人群筛选不同年龄健康受试者281名，其中男143名，女138名，年龄20-87岁，用酶偶联-两点法测定空腹血清1，5-AG，建立1，5-AG的正常参考值。同期随机选取门诊2型糖尿病（T2DM）患者38例，其中男女各19例，年龄37-74岁，给予重组赖脯胰岛素25治疗12周，每周规律监测餐前、餐后2h指尖血糖用以计算平均血糖（MBG），测定0、2、4、8、12周的1，5-AG、糖化血红蛋白（HbAlc）和糖化血清白蛋白（GA），比较各阶段不同血糖监测指标的变化，并行Pearson相关分析。结果健康人群的参考值范围：整体人群68-251μmol／L；男性80-267μmol／L，女性66-206μmol／L。健康人群1，5-AG水平号性别有关，男性高于女性；与年龄、体质指数（BMI）均无关。T2DM患者中，1，5-AG、HbAlc、GA与MBG均呈显著相关性（r=-0．491、0．563、0．422，均P〈0．01）；1，5-AG与2周内的MBG相关性最高（r=-0．675，P〈0．01），HbAlc与MBG的相关性维持时间最长。2周时1，5-AG升高了18．8％，而HbAlc和GA只分别降低了3．2％、6．2％。到12周，1，5-AG变化幅度为65．2％，仍明显高于HbAlc、GA的降低率（16．1％、21．1％）。T2DM患者个体的1，5-AG、HbAlc、GA、MBG随时间变化的一致性较好。结论1，5-AG的正常参考值：整体人群68-251μmol／L；男性80。267μmol／L，女性66-206μmol／L；1，5-AG作为短期血糖控制程度的标志，可能优于HbAlc和GA。Objective To establish the reference range of serum 1,5-anhydroglucitol（ 1,5-AG） in healthy people and analyze its correlation with short-term glycemic control. Methods From March to July in 2010, 281 individuals with normal glucose regulation, 143 men and 138 women aged from 20 to 87 years, were recruited from Gucheng and Pingguoyuan community in Beijing and outpatients of General Hospital of People＇s Liberation Army（PLA）. Serum 1,5-AG levels were measured with glucose kinase-pyranoid sugars oxidase （GK-PROD） methods in these individuals. Thirty-eight outpatients with type 2 diabetes, 19 men and 19 women aged 37 to 74 years, were selected from General Hospital of PLA and received mixed protamine zinc recombinant human insulin lispro injection （25R） interventions for 12 weeks. The blood glucose levels in the patients were regularly monitored before and 2b after main meals in order to obtain mean blood glucose （MBG） ; and 1,5-AG, glycosylated hemoglobin （ HbA1 c ） and serum glycated albumin （GA） were measured at week 0, 2,4,8 and 12 with clinic visits. Pearson correlation coefficient was used to measure the relation between 1,5-AG, HbAlc , GA and MBG. Results The normal range of serum 1,5- AG for healthy population could be suggested at 68 -251 μmol/L overall, 80 -267μmol/L for man and 66 - 206μmol/L for woman. The level of 1,5-AG in man was higher than that in woman, but there was no difference in the whole range of age and body mass index （BMI） in subjects. There were significant correlation between 1,5-AG, HbAlc, GA and MBG（r = - 0. 491,0. 563,0. 422, all P 〈 0. 01 ）. 1,5-AG was most closely associated with 2-week MBG level（r = -0. 675 ,P 〈 0. 01 ）, while the correlation between HbA1 c and MBG maintained longer than others. After treatment of 2 weeks, 1,5-AG increased by 18. 8%,but HbAlc and GA decreased by 3.2% and 6.2%. By week 12, 1,5-AG increased by 65.2% , while the HbAlc and GA decreased by 16. 1% and 21.1%. In general, there was satisfactory concordance be

关 键 词：糖尿病 2型 1 5-脱水葡萄糖醇 血红蛋白 糖基化 

分 类 号：R587.2[医药卫生—内分泌]