上海市青浦区低色素人群在不同血糖分层下其糖化血红蛋白的变化

目的研究上海市青浦区低色素人群空腹血糖(FBG)水平的分布情况,探讨该地区人群不同血糖分层下糖化血红蛋白(HbA1c)与平均红细胞血红蛋白(MCH)之间的关系。方法收集2016年9月至2017年9月在该院门诊就诊的14849例受试者标本,检测其FBG、HbA1c,分析在不同血糖分层下,MCH<27 pg和MCH≥27 pg受试者HbA1c水平的差异。两组间比较采用t检验,多组间比较采用方差分析。结果在FBG<5.6 mmol/L的8160例受试者中,MCH<27 pg的受试者HbA1c水平显著高于MCH≥27 pg的受试者,二者比较差异有统计学意义(P=0.000),但是FBG水平比较差异无统计学意义(P=0.142);在FBG为5.6~<7.0 mmol/L的2880例受试者中,MCH<27 pg的受试者HbA1c水平明显高于MCH≥27 pg的受试者,二者比较差异有统计学意义(P=0.003),但是FBG水平比较差异无统计学意义(P=0.119);在FBG≥7.0 mmol/L的3809例受试者中,MCH<27 pg的受试者与MCH≥27 pg的受试者HbA1c和FBG水平比较,差异均无统计学意义(P>0.05)。结论FBG<7.0 mmol/L时,如果MCH<27 pg(低色素人群),其HbA1c水平有假性升高,但MCH对HbA1c的影响会随着血糖的升高(FBG≥7.0 mmol/L)而逐渐消失。

Changes of glycated hemoglobin in low-pigmented populations in Qingpu district of Shanghai

Objective To study the distribution of fasting blood glucose(FBG)in low pigment population in Qingpu District of Shanghai,and to explore the relationship between glycosylated hemoglobin(HbA1c)and mean erythrocyte hemoglobin(MCH)in different blood glucose levels.Methods From September 2016 to September 2017,14849 outpatients were collected and their FBG and HbA1c were detected.The difference of HbA1c level between MCH<27 pg and MCH≥27 pg patients was analyzed under different blood glucose levels.T test was used for comparison between the two groups,and ANOVA was used for comparison between multiple groups.Results Among the 8160 subjects with FBG<5.6 mmol/L,the HbA1c level of the subjects with MCH<27 pg was significantly higher than that of the subjects with MCH≥27 pg(P=0.000),but there was no statistically significant difference in FBG level(P=0.142);among the 2880 subjects with FBG was 5.6 to 7.0 mmol/L,the HbA1c level of the subjects with MCH<27 pg was significantly higher than that of the subjects with MCH≥27 pg(P=0.003),but there was no significant difference in FBG level(P=0.119);among the 3809 subjects with FBG≥7.0 mmol/L,MCH<27 pg and those with MCH≥27 pg had no significant difference in HbA1c and FBG levels(P>0.05).Conclusion When FBG<7.0 mmol/L,if MCH<27 pg(low pigment population),the HbA1c level will increase falsely,but the effect of MCH on HbA1c will disappear gradually with the increase of blood glucose(FBG≥7.0 mmol/L).