住院2型糖尿病患者糖化血清白蛋白的临床意义及影响因素

目的检测2型糖尿病住院患者的糖化血清白蛋白（GA），评价GA作为一个反映短期平均血糖水平变化及住院期间血糖控制临床监测指标的可靠性。方法收集四川省人民医院内分泌科2012年2—8月住院的301例2型糖尿病患者，测定空腹血糖（FPG）、餐后2h血糖（2hPG），1d指尖血糖谱均值（MBG）、GA、糖化血红蛋白（HbAlc）等，并对住院第12天的患者复查GA、HbAIC、FPG、2hPG、MBG等指标，其中GA以液态酶法（GA-L）测定。结果（1）301例2型糖尿病患者中，GA与HbAlC（回归系数=1．585，t=3．319，P〈0．01）、2hPG（回归系数=0．395，t=2．255，P〈0．05）、MBG（回归系数=0．744，t=2．099，P〈0．05）均呈正相关。（2）301例住院第12天的2型糖尿病患者GA为（25．66±7．35）％，显著低于人院第1天的（36．91±8．18）％（t：14．441，P〈0．01）。（3）301例住院第12天的2型糖尿病患者GA／HbAlc较入院第1天下降[（2．92±1．45）％与（3．91±1．00）％，t：5．845，P〈0．01]。（4）糖尿病患者的GA值与体质量指数（BMI）呈负相关（回归系数=-0．339，t=-1．887，P〈0．05）。结论（1）GA可准确、及时地反映短期内平均血糖水平的变化，比HbAlC更适合作为评价2型糖尿病患者住院期间（12d）降糖效果的临床监测指标。（2）在评估糖尿病患者的GA值时，需考虑到BMI的因素，尤其在肥胖和消瘦的患者。

Clinical significant and influential factors of the glycated albumin in type -2 diabetes mellitus patients

Objective To investigate the change of the serum glycated albumin（GA） level in diabetic inpatients and to assess its reliability as a clinical marker for short-term blood glucose level and blood glucose control of diabetic in type -2 diabetes mellitus （T2DM） patients. Methods Three hundred and one patients with T2DM,who were hospitalized in Sichuan Provincial People＇s Hospital endocrinology department from February 2012 to August 2012 ,were enrolled in the present study. The fasting plasma glucose（FPG） ,2 h post-prandial glucose （2hPG）, 1 d fingertip blood glucose spectrum mean （MBG）, GA, and glycated hemoglobin （HbA1 c） were measured and recheck at the 12th d of hospitalized. GA level were measured in terms of GA-1 levels. Results （ 1 ）The GA level was positively correlated with HbA1 c, 2hPG, MBG （/3 = 1. 585,0. 395,0. 744 respectively, t = 3.319,2. 255,2. 099 respectively, P 〈 0.01, P 〈 0. 05, P 〈 0. 05 ）. （ 2 ） The GA level was （ 25.66 ± 7.35 ）% at the 12th d after admission, significantly lower than that at the first day of admission （ （36. 91 ± 8. 18 ） %, t = 14. 441, P 〈 0. 01 ）. （ 3 ） Compared with the 1 st day, the level of GA/HbA1 c was decreased siguificantly at the 12th day（ （3.91 ± 1.00） % vs. （ 2. 92 ±1.45 ） %, t = 5. 845, P 〈 0. 01 ）. （ 4 ） GA value was negatively correlated with body mass index （BMI） （β = -0. 339, t = - 1. 887, P 〈 0. 05 ）. Conclusion （1） GA can accurately, promptly reflect the change of glyccmic level and it might serve as the clinical monitoring marker for evaluating the glucose control in T2DM. （2） BMI should be concerned when assessing GA value of DM patients.