糖化血红蛋白用于糖尿病及糖尿病前期诊断的研究

目的探讨糖化血红蛋白诊断糖尿病及糖尿病前期的切点。方法依据2009年闵行区某社区糖尿病流行病学调查资料．利用ROC曲线分析糖化血红蛋白诊断糖尿病和糖尿病前期的最佳切点。结果在35岁以上人群糖化血红蛋白诊断糖尿病最佳切点为5．8％,ROC曲线下面积为0．933,灵敏度、特异度分别为87．91％和89．49％;糖化血红蛋白诊断糖尿病前期的切点为5．7％,ROC曲线下面积为0．827,灵敏度、特异度分别为62．10％和92．06％。结论HhAle作为诊断糖尿病的指标具有可行性．其灵敏度和特异度都较高。     

用糖化血红蛋白诊断糖尿病

一直以来,糖化血红蛋白都被用于检测前两三个月内的平均血糖水平。但美国糖尿病学会(ADA)特别推荐,如果检查发现,糖化血红蛋白水平高于6.5%就可初步判断为2型糖尿病,如果在5.7%～6.4%之间,可诊断为糖尿病前期。     

糖化血红蛋白对诊断糖尿病的分析

在这个极速发展的经济社会中,丰富物质供给不断冲击着人们的生活。如今的中国已经走上小康大道,然而,在温饱不愁的今天,新的问题走进了我们的视野——糖尿病,也有人称之为富贵病。而近年所流行的糖化血红蛋白对糖尿病的诊断,已引起医学卫生界以及整个社会的高度关注。本文探讨分析了糖化血红蛋白对糖尿病的诊断的问题。     

糖化血红蛋白异常诊断糖尿病1例

糖尿病(Diabetes Mellitus,DM)是一种多病因、以慢性血葡萄糖水平增高为特征的一种代谢性疾病.DM的发病率有逐年上升的趋势,如果能做到早预防、早发现,对于延长病人寿命,减少并发症及减少国家的医疗支出等具有重要意义.本文就1例DM的发现过程作介绍,供临床参考.     

控制糖化血红蛋白在儿童糖尿病中的临床应用

目的:观察糖尿病患儿糖化红血蛋白(HbA1c)控制情况,了解其在糖尿病控制中的应用价值。方法:选取2009年1月1日～12月31日已确诊的糖尿病在北京儿童医院内分泌科复诊的患儿591例,检测其HbA1c水平。按性别分为男、女两组;按发育情况分为青春前期组和青春发育期组;按HbA1c的控制情况,在年龄分组的基础上分为控制理想、可接受、较差、差4组。用SPSS软件进行统计学分析。结果:男性患儿的HbA1c平均水平为(8.81±4.24)%,女性患儿的HbA1c平均水平为(8.77±3.77)%;不同性别之间HbA1c水平差异无统计学意义(P>0.05)。青春前期组的HbA1c平均水平为(7.97±1.60)%;青春发育期HbA1c平均水平为(9.28±2.47)%,两个年龄组之间差异有统计学意义(P<0.01),青春发育期HbA1c水平明显高于青春前期组。青春前期组患儿HbA1c控制较理想的比例明显高于青春发育期组(P<0.05),青春发育期组患儿HbA1c控制差的比例明显高于青春前期组(P<0.01)。结论:青春前期组的患儿因由家长监督依从性较好,HbA1c水平控制较好,青春发育期组的糖尿病患儿应加强糖尿病知识的健康教育,加强精神心理方面的治疗,制定个性化的治疗方案,减少并发症。     

糖化血红蛋白在糖尿病诊断和筛查中的价值

糖尿病在现有诊断及筛查中的不足使得糖化血红蛋白（HbA1c）的检测越发显得重要,HbA1c在糖尿病诊断和筛查中优越性及合理性都显示了它的价值,一些对于HbA1c检测的影响因素及对影响因素的排除。     

糖化血红蛋白及糖化血清蛋白诊断妊娠糖尿病的意义

目的探讨糖化血红蛋白（Hb Alc）与糖化血清蛋白（GSP）检测诊断妊娠糖尿病的临床意义。方法选择2010年5月—2014年1月48例确诊为妊娠糖尿病（GDM）的孕妇作为观察组,并选择同期50名正常孕妇作为对照组,比较两组血清Hb Alc和GSP水平、Hb Alc和GSP异常人数。结果与对照组比较,观察组血清Hb Alc和GSP水平均明显增高（P〈0.05）;观察组Hb Al和GSP异常人数所占比例（85.42%、87.50%）明显高于对照组（52.00%、48.00%）（P〈0.05）。结论检测妊娠糖尿病患者血清Hb Alc和GSP水平对妊娠糖尿病的诊断有着重要的临床意义。     

糖化血红蛋白及糖化白蛋白在妊娠期糖尿病诊断中的价值

目的:分析糖化血红蛋白及糖化白蛋白在妊娠期糖尿病的诊断价值。方法:收集收治的孕妇485例,检测GDM患者HbA1c和GA浓度,统计分析其对妊娠期糖尿病的诊断价值。结果:GDM组血糖和HbA1c浓度明显高于对照组,P<0.05,差异有统计学意义;GA之间差异无统计学意义(P>0.05)。对两组进行Pearson相关分析发现,血糖浓度与HbA1c浓度呈正相关(r=0.213,P<0.01),HbA1c、血糖与GA均无相关性(r=0.110,r=0.042,P>0.05,P>0.05)。以对照组HbA1c95%作为GDM诊断的依据,该值特异性93.54%,敏感性88.13%,阴性预测值94.12%,阳性预测值87.04%,假阳性率6.46%,假阴性率11.87%。结论:HbA1c较GA对GDM的诊断更具有价值,但GA和HbA1c尚无法完全取代OGTT诊断GDM。对诊断和筛查GDM仍需要进行进一步的实验研究,以期能够发现更为确切的关系。     

糖化血红蛋白在糖尿病诊断中的临床意义

目的:探讨糖化血红蛋白在糖尿病诊断中的临床意义。方法:选择200例糖尿病患者为实验组,正常人100例为对照组。研究两组中糖化血红蛋白与空腹血糖的相关性。结果:实验组糖化血红蛋白与空腹血糖呈正相关,实验组与对照组糖化血红蛋白与空腹血糖之间的差异有统计学意义。结论:在糖尿病的临床诊断中,糖化血红蛋白的检测具有重要的临床意义。     

Diabetes and Prediabetes Inhibit Reversion from Mild Cognitive Impairment to Normal Cognition

ObjectivesDiabetes and prediabetes contribute to an increased risk of cognitive decline and dementia. Currently, it remains unclear whether elevated blood HbA1c levels, including prediabetes levels, affect reversion from mild cognitive impairment (MCI) to normal cognition. This study, therefore, aimed to examine the prospective associations of diabetes and prediabetes with reversion from MCI to normal cognition among community-dwelling older adults.DesignLongitudinal cohort study with a 4-year follow-up.Setting and ParticipantsCommunity-dwelling older adults with MCI, aged ≥65 years at baseline (n = 787).MethodsParticipants’ medical history of diabetes and blood HbA1c levels at baseline were assessed, and they were classified as control, prediabetes, and diabetes. Objective cognitive screening was performed using a multicomponent neurocognitive test at baseline and follow-up. Reversion from MCI to normal cognition over 4 years was determined. In the longitudinal analysis, we performed multiple imputations to adjust for a selection bias and loss of information.ResultsThe reversion rates of MCI in the control, prediabetes, and diabetes groups were 63.4%, 55.6%, and 42.9%, respectively, in the completed follow-up dataset, and 54.6%, 47.2%, and 34.1%, respectively, in the imputed dataset. Multivariate logistic regression showed that diabetes decreases the probability of MCI reversion both before and after multiple imputations [odds ratio (OR) 0.37; 95% confidence interval (CI) 0.18–0.74 for before imputation, OR 0.37; 95% CI 0.19–0.72 for after imputation]. Furthermore, prediabetes also showed significantly decreased probabilities of MCI reversion both before and after multiple imputations (OR 0.57; 95% CI 0.34–0.94 for before imputation, OR 0.60; 95% CI 0.37–0.97 for after imputation).Conclusions and ImplicationsDiabetes and prediabetes could inhibit MCI reversion. Adequate glycemic control may be effective in enhancing the reversion from MCI to normal cognition in a community setting.     

Lactobacillus plantarum HAC01 Supplementation Improves Glycemic Control in Prediabetic Subjects: A Randomized,Double-Blind,Placebo-Controlled Trial

A recent animal study demonstrated that administration of Lactobacillus plantarum HAC01 isolated from Korean kimchi improved glycemic control in type 2 diabetic mice. In the present study, we evaluated Lactobacillus plantarum HAC01’s effects on metabolic parameters of prediabetic human subjects. Forty subjects with isolated impaired glucose tolerance were randomly assigned to receive a daily placebo (n = 20) or a dose of Lactobacillus plantarum HAC01 (n = 20) over eight weeks. The primary endpoint was a change in 2 h postprandial glucose (2h-PPG) levels and the secondary endpoints were assessment of other glucose metabolism parameters, including HbA1c, gut microbiota composition, and fecal short-chain fatty acids (SCFAs). The group with a diet supplemented with Lactobacillus plantarum HAC01 saw a significant reduction in 2h-PPG and HbA1c levels compared to the placebo group. Fasting plasma glucose, insulin, HOMA-IR, QUICKI, microbiota composition, and fecal SCFAs, however, were not significantly altered. No serious adverse effects were reported. This is the first clinical trial to show a beneficial effect of single-strain probiotic supplementation administered over eight weeks on HbA1c levels in prediabetic subjects.     

瑞格列奈联合甘精胰岛素治疗Ⅱ型糖尿病临床观察

目的:观察瑞格列奈联合甘精胰岛素治疗Ⅱ型糖尿病的效果。方法:选择86例Ⅱ型糖尿病患者,连续治疗观察12周,每周根据血糖调整剂量,在治疗前后测定空腹和餐后2 h血糖,糖化血红蛋白、血脂、血压、体重指数及低血糖发生率。结果:在治疗前后空腹血糖(FBG),餐后2 h血糖(PBG)及糖化血红蛋白(HbA1c),均有明显下降(P<0.01)。血脂中甘油三脂(TG)在治疗前后亦有统计学差异(P<0.05),而血压、体重指数在治疗前后无统计学意义(P>0.05)。有3例发生轻微低血糖。结论:在Ⅱ型糖尿病治疗中应用瑞格列奈联合甘精胰岛素可有效的降低血糖及糖化血红蛋白,且安全性高。     

The Beneficial Effects of Astaxanthin on Glucose Metabolism and Modified Low-Density Lipoprotein in Healthy Volunteers and Subjects with Prediabetes

Astaxanthin (ASTX) is an antioxidant agent. Recently, its use has been focused on the prevention of diabetes and atherosclerosis. We examined the effects of astaxanthin supplementation for 12 weeks on glucose metabolism, glycemic control, insulin sensitivity, lipid profiles and anthropometric indices in healthy volunteers including subjects with prediabetes with a randomized, placebo-controlled trial. Methods: We enrolled 53 subjects who met our inclusion criteria and administered them with 12 mg astaxanthin or a placebo once daily for 12 weeks. Subsequently, their HbA1c levels, lipid profiles and biochemical parameters were determined. The participants also underwent a 75 g oral glucose tolerance test (OGTT), vascular endothelial function test and measurement of the visceral fat area. Results: After astaxanthin supplementation for 12 weeks, glucose levels after 120 min in a 75 g OGTT significantly decreased compared to those before supplementation. Furthermore, the levels of HbA1c (5.64 ± 0.33 vs. 5.57 ± 0.39%, p < 0.05), apo E (4.43 ± 1.29 vs. 4.13 ± 1.24 mg/dL, p < 0.05) and malondialdehyde-modified low-density lipoprotein (87.3 ± 28.6 vs. 76.3 ± 24.6 U/L, p < 0.05) were also reduced, whereas total cholesterol (TC), triglyceride (TG) and high-density lipoprotein-C (HDL-C) levels were unaltered. The Matuda index, which is one of the parameters of insulin resistance, was improved in the ASTX group compared to that before supplementation. Conclusions: our results suggest that ASTX may have preventive effects against diabetes and atherosclerosis and may be a novel complementary treatment option for the prevention of diabetes in healthy volunteers, including subjects with prediabetes, without adverse effects.     

基于SOC单片机的糖化血红蛋白分析仪设计

介绍TDS5糖化血红蛋白检测仪的改进方案,分析了系统硬件和软件的结构和工作流程;改进后的系统具有结构简单,便于升级和管理等诸多优点,具有良好的应用前景和可观的市场价值。     

入院时糖化血红蛋白A1与脑出血患者预后的关系

目的 探究自发性脑出血（ICH）患者入院时糖化血红蛋白A1（HbA1c）水平与脑出血后90 d预后之间的关系。方法 前瞻性连续纳入2017年1-12月同济医院神经内科住院ICH患者,收集患者入院时相关临床资料,在患者出血后90 d使用改良的RANKIN量表评估其功能结局。构建单变量及多变量条件logistic回归模型,根据HbA1c测量值的四分位数将患者分为4组,以每组患者HbA1c的M为替代值纳入模型,计算趋势检验P值。应用限制性立方样条法拟合logistic回归模型,评估入院时HbA1c水平与ICH预后的关系。结果 共纳入ICH患者345例,其中预后良好214例,预后不良131例（严重残疾99例,死亡32例）。多因素logistic回归分析结果显示,随着入院时HbA1c升高,ICH后90 d发生预后不良的风险升高,趋势检验P<0.001（与HbA1c低水平组相比,中、高及极高水平组90 d预后不良的风险分别为OR=2.33,95%CI：1.07~5.07;OR=2.52,95%CI：1.12~5.64;OR=6.80,95%CI：3.01~15.34）。限制性样条结果显示,入院时HbA1c水平与ICH患者出血后90 d预后不良之间具有相关性（χ²=14.81,P<0.001）,且为线性关系（非线性检验：P=0.118）。入院时HbA1c<6.5%的患者与HbA1c=6.5%的患者相比,随着HbA1c含量的降低,预后不良的风险呈线性降低趋势;HbA1c>6.5%的患者与HbA1c=6.5%的患者相比,预后不良的风险更大,但差异无统计学意义。结论 入院时HbA1c水平升高与出血后90 d时预后不良风险有联系,HbA1c升高是脑出血预后不良的独立预测因子。     

成年人吸烟状态与糖化血红蛋白及胰岛素的关系

目的 探讨成年人不同吸烟状态与糖化血红蛋白（HbA1c）和胰岛素水平的关系。方法 多阶段分层随机整群抽样的方法抽取徐州地区18岁及以上的常住居民,进行问卷调查、体格测量和实验室检查。多元线性回归模型分析吸烟状态与HbA1c及胰岛素水平之间的关系。结果 HbA1c水平的比较显示,被动吸烟组和不吸烟且无被动吸烟组的HbA1c均低于现在吸烟组（P＜0.01）,曾经吸烟组、被动吸烟组和不吸烟且无被动吸烟组的服糖后2 h胰岛素均高于现在吸烟组的服糖后2 h胰岛素（P＜0.01）。结论 吸烟和被动吸烟可能是引起HbA1c异常的相关因素。     

HbA1c预测值所引导的2型糖尿病患者个体化自我管理教育研究

目的探讨HbA1c预测值所引导的2型糖尿病患者个体化自我管理教育模式对糖尿病控制效果的影响.方法对60例2型糖尿病患者的糖尿病基本知识、饮食、运动及用药自我管理能力进行问卷调查,检测糖尿病控制指标,建立HbA1c预测值模型.被调查者随机进入用HbA1c预测值所引导的个体化自我管理教育组(A组)和小组教育组(B组),每组30例.干预第3、6、9个月末检测血糖指标.第12个月末,再次进行问卷调查和检测控制指标.结果两组的各项检测指标均较干预前明显变好,糖尿病基本知识积分增加.A组自我管理能力增强的人数比率明显高于B组(Fisher精确概率双侧检验P＜0.05),糖尿病血糖指标控制效果好于B组(t＞2.11,P＜0.05).结论用HbA1c预测值所引导的2型糖尿病患者个体化自我管理教育是一种有效长期维持糖尿病控制效果的干预方法.