空腹和餐后2h血糖与糖化血红蛋白关联度的研究  

Study on the correlation between HbA1c and fasting plasma glucose or 2 h plasma glucose

作　　者：沈雄文[1] 孙关忠[1] 裘敏丽[1] 谭焕腾[1] 

机构地区：[1]中国人民解放军第一一七医院检验科,浙江杭州310013

出　　处：《国际检验医学杂志》2013年第16期2083-2084,2086,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨空腹血糖(FPG)和餐后2h血糖(2h-PG)对糖化血红蛋白(HbA1c)的相关性,影响HbA1c水平的因素,以及HbA1c用于血糖控制效果评估的价值。方法选取健康体检者1001人作为对照组,糖代谢异常患者1422例。糖代谢异常患者分为3组分别为Ⅰ组:HbA1c<5.7%,Ⅱ组:5.7%≤HbA1c<6.5%和Ⅲ组:HbA1c≥6.5%,剔除离群值,作多重回归分析。观察相关系数、偏回归系数及标准回归系数,推断FPG和2h-PG对HbA1c的贡献度。结果随HbA1c的增高,线性回归的相关性增强,常数项随HbA1c的增加而增加。糖尿病组的相关性最好,r2为0.890。FPG对HbA1c的贡献较大,2h-PG的贡献在Ⅱ组最大,标准偏回归系数为0.265。结论影响HbA1c的主要因素是FPG,HbA1c降低主要依赖空腹血糖的降低,并且HbA1c难以反映2h-PG的控制情况,部分达到或接近HbA1c控制目标的患者可能出现过低的空腹血糖和不受控制的2h-PG,糖尿病患者的HbA1c检测不应该取代2h-PG的监控。Objective To establish a regression model between fasting plasma glucose（FPG）,2-hour postprandial glucose（2h-PG） and glycated hemoglobin（HbA1c）.To investigate the influencing factor on HbA1c level,and evaluate the use of HbA1c as an indicator in blood glucose control.Methods 1 001 healthy people were enrolled as control group,and 1 422 patients with abnormal glucose metabolism were as abnormal glucose metabolism group,which was divided into three smaller groups including group Ⅰ：HbA1c＆lt;5.7%,group Ⅱ：5.7%≤HbA1c＆lt;6.5% and group Ⅲ：HbA1c≥6.5%.Outliers were excluded and data left were dealt with multiple regression analysis.The correlation coefficient,partial regression coefficient and standardized regression coefficients were calculated,then the contribution of FPG and 2h-PG to HbA1c was concluded.Results Linear regression correlation enhanced with the increase of HbA1c level and constant term increases with the increasing of HbA1c too.Group Ⅲ has the best correlation,the R2 of which was 0.890.FPG contribution much more to HbA1c,2h- FPG contribution much to Group Ⅱ,and standardized partial regression coefficient is 0.265.Conclusion The main factors affecting the HbA1c is FPG,the reduction of HbA1c depends on lower FPG,and HbA1c is difficult to reflect the control of 2h-PG.Some patients who have reached or nearly reached the HbA1c control targets may still have too low level of FPG or 2h-PG out of control.The HbA1c level measurement should not take the place of 2h-PG test in diabetes monitoring.

关 键 词：糖尿病 2型 血糖 血红蛋白A 糖基化 

分 类 号：R587.1[医药卫生—内分泌]