糖化血红蛋白及糖化清蛋白水平对糖尿病视网膜病变的诊断价值分析  

Diagnostic Value of Glycocsylated Hemoglobin A1c and Glycated Albumin Levels in Diabetic Retinopany

作　　者：季雄娟 邵静 陆胜 JI Xiong juan;SHAO Jing;LU Sheng(Department of Clinical Laboratory,Wuxi City Xishan People＇s Hospital,Jiangsu Wuxi 214000,China;Department of Clinical Laboratory,Yancheng City Da f eng People~ s Hospital,J iangsu Yancheng 224100,China)

机构地区：[1]无锡市锡山人民医院检验科,江苏无锡214000 [2]盐城市大丰人民医院检验科,江苏盐城224100

出　　处：《现代检验医学杂志》2018年第5期77-81,共5页Journal of Modern Laboratory Medicine

摘　　要：目的探讨糖化血红蛋白(glycocsylated hemoglobin A1c,HbA1c)及糖化清蛋白(glycated albumin,GA)水平对糖尿病视网膜病变(diabetic retinopany,DR)的诊断价值及诊断截点。方法将500例2型糖尿病(type 2diabetes mellitus,T2DM)患者依据视网膜病变诊断标准,分为无视网膜病变组(non-DR,NDR)215例、背景期视网膜病变组(backgroundDR,BDR)183例以及增殖期视网膜病变组(proliferative-DR,PDR)102例,同时选择165例健康体检者作为正常对照组。检测各组空腹血糖(fasting plasma glucose,FPG)、餐后2h血糖(postprandial 2hblood glucose,2hPG)、HbA1c和GA水平。采用Pearson相关分析评估GA,HbA1c与DR的关系;采用受试者工作特征(receiver operating characteristic,ROC)曲线评价GA及HbA1c对DR的诊断价值。结果 NDR组、BDR组及PDR组各检测指标水平逐渐增高,各组之间差异均有统计学意义(F=7.936～11.348,均P<0.05)。患者组GA,HbA1c与FPG,2hPG均呈正相关(r值分别为0.754,0.782,0.691,0.782,均P<0.05);GA,HbA1c诊断DR的ROC曲线下面积(area under curve,AUC)分别为0.932和0.856,GA的AUC较大,两者比较,差异有统计学意义(P<0.05)。结论 GA和HbA1c能反映DR的严重程度;GA和HbA1c诊断DR的最佳截点约为19.25%和8.05%;GA在DR的诊断效能上高于HbA1c。Objective To investigate the diagnostic value and diagnostic cut off point of glycocsylated hemoglobin Alc and （HbAlc） glycated albumin （GA） levels in diabetic retinopathy （DR）. Methods According to the criteria of DR, 500 pa dents with type 2 diabetes mellitus （T2DM） were classified into non diabetic retinopathy （NDR） group （215 cases）, back ground diabetic retinopathy （BDR） （183 cases） and proliferative diabetic retinopathy （PDR） group （102 cases）, while 165 healthy subjects were selected as the normal control group. The levels of fasting plasma glucose （FPG）, postprandial 2h blood glucose （2hPG）, glycocsylated hemoglobin Alc （HbAlc） and glycated albumin （GA） were measured. The relationship between GA and HbAlc and DR was evaluated by Pearson correlation analysis. The diagnostic value of GA and HbAlc in diabetic retinopathy was evaluated by the receiver operating characteristics （ROC） curve. Results The levels of NDR group,BDR group and PDR group gradually increased, the difference between the groups were statistically significant （F= 7. 936~11. 348, all p〈0.05）. There was a positive correlation between GA and HbAlc in patients and FPG and 2hPG （r= 0. 754,0. 782,0. 691 and 0. 782,all p〈0.05）. The area under the ROC curve of GA and HbAlc diagnosed DR was 0. 932 and 0. 856. The difference was statistically significant （p〈0.05）. Conclusion GA and HbAlc could reflect the severity of diabetic retinopathy. The optimal cutoff point of GA and HbAlc was about 19.25~ and 8.05~. The diagnostic efficiency of GA was higher than that of HbAlc.

关 键 词：空腹血糖 餐后两小时血糖 糖化血红蛋白 糖化清蛋白 糖尿病视网膜病变 

分 类 号：R587.2[医药卫生—内分泌] R446.112[医药卫生—内科学]