HbA1c体外代谢动力学研究  

Researth on HbA1c in vitro metabolic kinetics

作　　者：沈雄文[1] 孙关忠[1] 李静云[1] 胡云华[1] 裘敏丽[1] 

机构地区：[1]中国人民解放军第117医院检验科,浙江杭州310013

出　　处：《国际检验医学杂志》2012年第24期2988-2989,共2页International Journal of Laboratory Medicine

摘　　要：目的探索HbA1c与血糖浓度动态变化的规律,建立HbA1c反映血糖控制情况的理论基础。方法红细胞在不同浓度葡萄糖生理盐水中孵育,测量不同时间段不稳定型糖化血红蛋白(L-HbA1c)和稳定型糖化血红蛋白(S-HbA1c)值的变化,观察L-HbA1c(1～24h)和S-HbA1c(1～48h)浓度变化,计算两者初级反应时的生成速率,L-HbA1c合成的平衡常数及L-HbA1c与S-HbA1C转换比。结果 L-HbA1c升高程度随葡萄糖浓度的增加而增加。在4～8h达到最大,至少在8～20h内稳定,在孵育的前2h期间,L-HbA1c浓度增加呈线性,平均生成速率为0.033%/h/mmol葡萄糖/L;L-HbA1c在无葡萄糖的生理盐水中减少到孵育前浓度,平均降解速率为0.018%/h/mmol葡萄糖/L,平衡常数为1.83;S-HbA1c升高程度随葡萄糖浓度的增加呈线性增加,平均生成速率为0.003%/h/mmol葡萄糖/L;在无葡萄糖环境中,S-HbA1c浓度在24h内无显著变化。结论通过对HbA1c体外代谢动力学的初步探索,证实血糖控制较为稳定的2型糖尿病患者主要是由于餐后-空腹血糖差造成HbA1c水平差异较大而且还可推算出治疗后HbA1c的急剧变化和平均滞后时间。Objective To explore regularities of HbA1c and glucose concentration dynamic changes,establishing theoretical basis in HbA1c reflects the status of controlling blood glucose.Methods Red blood cells were incubated in physiological saline solution（PSS） with different concentrations of glucose,to measure the changes in different time for the L-HbA1c and S-HbA1c level,and to drawing glucose concentration vs T-HbA1c% curve.Observed in L-HbA1c（1-24 h） level and S-HbA1c（1-48 h） level changes,Calculated their formation rate of the primary reaction,the equilibrium constant of L-HbA1c synthesis reaction and L-HbA1c turn to S-HbA1c conversion ratio.Equilibrium constant is the ratio synthesis rate and degradation rate.Results L-HbA1c level increased with increasing concentration of glucose,attained the maximum in 4-8 hours,stabilized in 8-20 hours.first two hours after begin incubated,L-HbA1c level increased linearly,average rising rate was 0.033%/h/mmol glucose/L;L-HbA1c level will reduc in PSS without glucose till L-HbA1c level return to pre-incubated,average decreasing rate was 0.018%/h/mmol glucose/L.Equilibrium constant was 1.83;S-HbA1c level increased linearly with increasing concentration of glucose,average rising rate was 0.003%/h/mmol glucose /L;S-HbA1c level in PSS without glucose was no significant change in 24 hours.Conclusion Through preliminary study on HbA1c in vitro metabolic kinetics,understanding of stable glycemic control in 2 type diabetes patients who HbA1c difference is due to fasting-postprandial glycemic disparity.It also can be calculated dramatic changes and the lag time for HbA1c attain balance after treatment.

关 键 词：血糖 血红蛋白A 糖基化 动力学 体外研究 

分 类 号：R587.1[医药卫生—内分泌]