HbA1c对糖调节受损和2型糖尿病的诊断价值

摘要：目的：评估糖化血红蛋白（HbA1c）不同cut off值诊断2型糖尿病（T2DM）的效能,初步探讨美国糖尿病协会（ADA）推荐的HbA1c诊断T2DM及T2DM前期标准对中国人的适用性。 方法：招募接受口服葡萄糖耐量（OGTT）试验且试验前未诊治为T2DM的志愿者338例,用高效液相色谱法检测HbA1c;以WHO标准诊断糖调节受损（IGR）、糖耐量正常和T2DM;用受试者工作特征（ROC）曲线分析不同 cut off值HbA1c诊断IGR和T2DM的效能。 结果：HbA1c在诊断T2DM时,ROC曲线下面积（AUC^ROC）为0.954,最佳cut off值为6.0%,敏感性为92.5%,特异性为86.0%;当HbA1c为6.5%时,敏感性为64.8%,特异性为96.7%;当HbA1c为5.6%时,诊断T2DM阴性预测值为100.0%;HbA1c诊断IGR的AUC^ROC为0.653。 结论: HbA1c用于IGR的诊断效能不高;HbA1c诊断T2DM最佳cut off值为6.0%,此界值诊断敏感性较FPG高,但特异性较差;ADA推荐用于T2DM诊断的cut off值6.5%主要考虑到诊断的特异性,该诊断标准适用于中国人群。     

Prevalence of diabetes mellitus and impaired glucose tolerance in a middle-aged Finnish population

Objective - To describe the prevalence of previously diagnosed and undiagnosed diabetes and impaired glucose tolerance (IGT) by sex, marital status, employment, exercise behaviour, and body mass index (BMI), and to compare previously diagnosed and undiagnosed diabetic patients.

Design - A survey of the total 55-year-old population living in a Finnish city on 1 October 1990. All the participants who were not on antidiabetic medication were invited for an oral glucose tolerance test (OGTT).

Setting - Oulu, a city in northern Finland.

Subjects - 1008 eligible subjects (456 men and 552 women), of whom 345 men (76%) and 435 women (79%) participated.

Main results - the prevalence of previously diagnosed diabetes was 6.1% in the men and 3.0% in the women and that of previously undiagnosed diabetes 4.5% of the men and 3.7% of the women. the prevalence of IGT was 28.6% in the men and 26.7% in the women. Diabetes was related to BMI, and previously undiagnosed diabetes was related to the amount of physical exercise in both sexes. One third of the undiagnosed diabetic men and half of the undiagnosed diabetic women were identified among the persons with marked obesity (BMI 30 kg/m² or more). the group of previously diagnosed diabetic patients included a significantly greater proportion of retired people and people on sick leave than the group of undiagnosed diabetic persons.

Conclusions - Diabetes is common in middle-aged Finns. Undiagnosed diabetes was detected especially in persons with marked obesity who were not physically active.     

Levels of serum sialic acid and thiobarbituric acid reactive substances in subjects with impaired glucose tolerance and type 2 diabetes mellitus

Cardiovascular disease is a common cause of death for diabetic patients. High sialic acid levels (SA) and increased oxidative stress are important factors for cardiovascular diseases. We aimed to research whether SA and thiobarbituric acid reactive substances (TBARS) levels are associated with the degree of the diabetic regulation and investigate if SA and TBARS levels can be controlled with the regulation of the blood glucose levels. A total of 179 subjects were included in the study. Three groups, which were comprised of subjects with type 2 diabetes mellitus (DM) (DM group [DMG], n=149), impaired glucose tolerance (IGT) (IGT group [IGTG], n=15), and normal oral glucose tolerance (NGT) (NGTgroup [NGTG], n=15) were constituted. Glucose, cholesterol, high-density lipoprotein (HDL) and glycated hemoglobin (HbA1C), SA, and TBARS were measured in the sera of the patients. SA and TBARS levels were significantly increased in subjects with type 2 DM (P<0.001 for both). SA concentrations showed significant correlation with triglycerides (r=0.229; P<0.05), fasting glucose (r=0.508; P<0.01), 2-hr postprandial glucose (r=0.455; P<0.01), and HbA1C (r=0.467; P<0.01), and there was a positive correlation between TBARS and HbA1C (r=0.251; P<0.01). Diabetic patients were found to have higher risk for inflammation and oxidative stress. The regulation of blood glucose levels may contribute to the decline of both SA and TBARS levels.     

糖化血红蛋白对妊娠期糖尿病筛查及年龄依赖性发病率的价值探讨

目的探讨糖化血红蛋白(HbA1c)筛查妊娠期糖尿病(GDM)及年龄依赖性发病率的价值。方法美国糖尿病协会(ADA)葡萄糖耐量试验(OGTT)作为诊断GDM标准,将1 600例妊娠妇女(孕期24~28周)分为健康妊娠组1 319例、GDM组281例,同时测定2组HbA1c和空腹血糖(FPG)、1h及2h血糖,并进行统计学及受试者工作特征(ROC)曲线分析。结果 GDM组的HbA1c值显著高于健康妊娠组(P0.05)。当HbA1c诊断截点4.895%时,ROC曲线下面积(AUC)0.905,敏感性85.8%,特异性81.9%;FPG、1h血糖和2h血糖诊断GDM的ROC AUC分别为0.879、0.796及0.762。随着年龄的增加,不同年龄阶段GDM组中大于HbA1c诊断截点(4.895%)比例呈上升的趋势。结论随着年龄的增加,不同年龄阶段GDM组中HbA1c诊断GMD比例呈上升的趋势。OGTT与HbA1c联合检测能提高GDM诊断准确性,在GDM诊断及监测中有重要价值。     

HbA1c在妊娠期糖尿病筛查中的临床价值

目的评估糖化血红蛋白（HbA1c）在妊娠期糖尿病（GDM）筛查中应用的可能性。方法对同时进行75 g口服葡萄糖耐量试验（OGTT）和HbA1c检查的474例围产期门诊孕妇按美国糖尿病协会（ADA）标准分为GDM组（30例）和非GDM组（444例）,分析2组HbA1c结果。结果 GDM组HbA1c水平明显高于非GDM组（P〈0.01）;HbA1c筛查GDM的受试者工作特征（ROC）曲线下面积为0.969;当HbA1c的Cut-off值为5.4%时,筛查GDM的敏感性为73.0%、特异性为98.4%、阳性预示值为75.9%、可靠性为98.2%。结论 HbA1c可作为一个非常有希望的GDM筛查指标。     

Incidence of type 2 diabetes in southern Spain (Pizarra Study)

Background Few European studies have used an oral glucose tolerance test (OGTT) to examine the incidence of type 2 diabetes. We determined the incidence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes in a population from southern Spain. Material and methods A population‐based cohort study was undertaken in Pizarra, Spain. Baseline data were recorded on age, sex, weight, height, waist and hip circumferences, and diabetes status for 1051 persons, of whom 910 were free of type 2 diabetes (at‐risk sample). Of these, 714 completed the 6‐year follow‐up study. Body mass index, waist‐to‐hip ratio and weight increase since baseline were calculated. The homeostasis model assessment equations were used to estimate the indices of insulin resistance and β‐cell function. Each person received an OGTT at baseline and after 6 years. Results Type 2 diabetes developed in 81 people for a total of 4253 person‐years, representing an incidence of 19·1 cases per 1000 person‐years (95% confidence interval, 15·3–23·6). Age and the presence of obesity, central obesity and carbohydrate metabolism disorders [IFG (cut off = 100 mg dL^?1, capillary blood glucose level), IGT or both] at baseline were significant markers for the onset of type 2 diabetes during follow‐up. After adjusting for these variables, multivariate analysis showed weight increase, waist‐to‐hip ratio and the indices of insulin resistance and β‐cell function were significantly associated with the risk for type 2 diabetes. Conclusions The incidence of type 2 diabetes in a population from southern Spain is high. It is probably associated with the high prevalence of obesity and weight increase in this population.     

HbA1c在妊娠期糖尿病筛查中的临床价值

目的评估糖化血红蛋白(HbA1c)在妊娠期糖尿病(GDM)筛查中应用的可能性。方法对同时进行75 g口服葡萄糖耐量试验(OGTT)和HbA1c检查的474例围产期门诊孕妇按美国糖尿病协会(ADA)标准分为GDM组(30例)和非GDM组(444例),分析2组HbA1c结果。结果 GDM组HbA1c水平明显高于非GDM组(P<0.01);HbA1c筛查GDM的受试者工作特征(ROC)曲线下面积为0.969;当HbA1c的Cut-off值为5.4%时,筛查GDM的敏感性为73.0%、特异性为98.4%、阳性预示值为75.9%、可靠性为98.2%。结论 HbA1c可作为一个非常有希望的GDM筛查指标。     

动态血糖监测新发2型糖尿病患者糖耐量试验时的血糖变化

目的 探讨2型糖尿病患者口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)时的血糖变化特点.方法 采用动态血糖监测系统(continuous glucose monitoring system,CGMS)对35例新诊断的2型糖尿病患者和24例糖代谢正常者进行动态血糖监测,同时进行75 g葡萄糖的OGTT,比较两组在不同糖代谢状态下糖负荷后3小时内平均血糖值(MBG)、血糖峰值(PPG)、血糖达峰时间(△t)、血糖波动幅度(PGE)和血糖的曲线下面积增值(IAUC)变化.结果 2型糖尿病组OGTT 3小时的MBG、PPG、△t、PGE和IAUC显著高于对照组,分别为 (11.6±13.16) mmol/L vs (7.66±0.80) mmol/L、(14.21±3.79) mmol/L vs (9.09±1.09) mmol/L、(117.09±36.84) min vs (84.04±34.17) min、(6.30±2.87) mmol/L vs (2.96±0.87) mmol/L、(3.22±1.97) mmol·L-1·d vs (1.69±0.71) mmol·L-1·d(均P<0.01).2型糖尿病患者OGTT 2小时血糖达到诊断标准的占68.6%(24/35),与未达该标准的31.4%(11/35)相比,MBG、PPG、PGE和IAUC均明显增高(均P<0.01),分别为(12.99±2.70) mmol/L vs (8.46±0.82) mmol/L、(15.97±3.24) mmol/L vs (10.41±1.15) mmol/L、(7.49±2.44) mmol/L vs (3.70±1.89) mmol/L、(4.02±1.73) mmol·L-1·d vs (1.47±1.21) mmol·L-1·d;△t的差异无统计学意义(P＞0.05).2型糖尿病组在不同糖化血红蛋白水平时,OGTT时除MBG有显著差异外(P<0.05),PPG、PGE和IAUC的差异均无统计学意义(均P＞0.05);而在不同空腹血糖状态时,OGTT的血糖波动指标差异均无统计学意义(P＞0.05).结论 新发2型糖尿病患者在糖负荷状态下血糖波动加剧,达峰时间延迟;筛查2型糖尿病时,对OGTT 2小时血糖接近标准值上限或糖耐量异常者应复查OGTT以减少漏诊.     

糖耐量受损和2型糖尿病患者脂联素水平的相关性研究

目的探讨在糖耐量受损及2型糖尿病患者中血脂血糖、胰岛素抵抗和血清脂联素之间的关系。方法 166例分为正常对照组（29例）、糖耐量受损组（41例）和糖尿病组（96例）,分别检测血脂、血糖、血胰岛素水平和血清脂联素,采用HOMA-IR法计算胰岛素抵抗指数。分别对正常组是否进展为糖耐量受损,以及糖耐量受损是否进展为糖尿病进行二分类Logistic回归分析。结果正常对照组、糖耐量受损组和糖尿病组血清脂联素水平分别为（15.8±3.6）、（10.7±2.4）和（6.3±2.4）mg/L,3组间差异有显著统计学意义（P〈0.05）。糖耐量受损组的体质指数、总胆固醇、胰岛素水平和胰岛素抵抗显著高于正常组（P均〈0.05）。Logistic回归分析表明体质指数、高密度脂蛋白胆固醇、空腹胰岛素、胰岛素抵抗指数为正常对照进展为糖耐量受损的危险因素。当糖耐量受损组进展为糖尿病组时,空腹胰岛素是唯一有统计学差异的危险因素。脂联素在两个阶段中都为保护因素。结论在糖耐量受损时胰岛素抵抗水平升高,并已伴随脂联素水平下降。血清脂联素测定,可作为2型糖尿病的辅助诊断、及早干预的指标。     

初诊2型糖尿病患者糖化血红蛋白与并发症的关系

目的 探讨初诊2型糖尿病(T2DM)患者糖化血红蛋白(HbA1c)与糖尿病并发血管病变和肾功能损害的关系.方法 对221例初诊T2DM患者行颈动脉彩色多普勒超声波检查[颈动脉内膜至中膜厚度(IMT)＞1.3 mm诊断为血管病变,纳入血管病变组,反之纳入血管正常组],并检测尿微量清蛋白(mAlb)>22.5 mg/L诊断为肾功能损害,为RI组;mAlb 0~2.25 mg/L为肾功能正常,纳入NR组.利用ROC曲线分析不同切点HbA1c值,判断糖尿病并发血管病变和肾功能损害的敏感性和特异性.结果 HbA1c在不同切点HbA1c≥6.75%、HbA1c≥6.85%、HbA1c≥7.35%,诊断初诊T2DM 患者并发血管或肾功能损害、血管病变、肾功能损害的敏感度和特异性分别是93.4%和77.4%(ROC=0.929),91.7%和76.8%(ROC=0.918),85.7%和91.4%(ROC=0.943).结论 HbA1c用于早期预测诊断DM并发血管病变和肾功能损害具有较高的敏感度和特异性,对防治糖尿病并发血管病变和肾功能损害有重要意义.     

HbA_(1c)诊断2型糖尿病特性观察及在空腹血糖正常人群中的分布特征研究

目的观察糖化血红蛋白(HbA1c)诊断2型糖尿病(T2DM)的特点及其在空腹血糖(FPG)正常者中的分布情况。方法同时测定729例FPG正常者尿酸(UA)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C);用免疫抑制比浊法测定247例接受口服葡萄糖耐量试验(OGTT)者(包括T2DM 164例、糖耐量受损41例、空腹血糖受损18例、糖耐量正常者24例)的HbA1c,以OGTT和临床诊断结果作为标准,绘制HbA1c和FPG的受试者工作特征(ROC)曲线,确定HbA1c诊断T2DM的切点,通过对比分析观察不同性别及同性别不同年龄组中HbA1c的分布情况。结果免疫抑制比浊法测定HbA1c诊断T2DM的切点为6.36%,诊断灵敏度为86.50%、特异性为90.60%、阳性预测值为94.63%、阴性预测值为76.50%、曲线下面积为0.944[95%可信区间(CI):0.917~0.971],FPG7.0 mmol/L时诊断糖尿病的灵敏度为85.90%、特异性为93.80%、曲线下的面积为0.957[95%CI:0.932~0.981]。FPG正常者中女性HbA1c、HDL-C水平明显高于男性(P=0.000),男性血红蛋白(Hb)、FPG、UA、TG水平高于女性(P值分别为0.000、0.020、0.000、0.000)。随着年龄的增加,男、女性HbA1c、FPG、TC和LDL-C均有增高的趋势;特别是在60岁以后,女性HbA1c升高更高明显;但HDL-C在男性中有上升的趋势,在女性中有下降的趋势。结论免疫抑制比浊法测定HbA1c诊断T2DM的切点为6.36%,随着年龄的增加要定期测定HbA1c,以达到预防糖尿病的目的。     

Assessing progression to impaired glucose tolerance and type 2 diabetes mellitus

BACKGROUND: A prospective evaluation of the relationship between insulin secretion and insulin sensitivity, derived from the fasting state, is needed in clinical practice in order to identify the worsening of glucose metabolism. In this study the authors examine whether the product of insulin sensitivity and insulin secretion, assessed from the fasting state, predicts progression from normal glucose tolerance (NGT) to impaired fasting glucose (IFG) and from impaired glucose tolerance (IGT) to type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: A cohort of 300 subjects with NGT and 75 subjects with IGT were followed up over a 5-year period. Insulin sensitivity was calculated using the Belfiore index (B) and insulin secretion by the homeostasis model analysis beta-cell (HOMA-beta cell) index: the product of B-beta is expressed as: (40 x Ins(0) pmol L(-1))/Glu(0) mmol L(-1){[(Glu(0) mmol L(-1)x Ins(0) pmol L(-1)) + 1] - 3.5[(Glu(0) mmol L(-1) x Ins(0) pmol L(-1)) - 1]}, where Glu(0) is fasting glucose and Ins(0) is fasting insulin. RESULTS: From baseline at the end of the follow-up period, the product B-beta decreased 10.7% and 52.2% in progressors to IGT and T2DM, respectively. The product B-beta predicts the progression from NGT to IGT [relative risk (RR) 2.7, CI(95%) 1.2-9.1] and from IGT to T2DM (RR 5.3, CI(95%) 1.3-8.55). The cut-off point for the product B-beta that better predicts progression from NGT to IGT is 0.25 (sensitivity 88%, specificity 92%) and from IGT to T2DM 0.15 (sensitivity 92%, specificity 95%). CONCLUSIONS: Adaptation of insulin secretion to compensate for decreased insulin sensitivity during transition to IGT and T2DM can be successfully assessed with simple measures derived from the fasting state. The product B-beta predicts the development to IGT and T2DM.     

Both youth and long-term vitamin D status is associated with risk of type 2 diabetes mellitus in adulthood: a cohort study

Objectives: To determine whether vitamin D status in childhood and adolescence (herein collectively referred to as youth) and the long-term status from youth to adulthood is associated with risk of developing type 2 diabetes mellitus (T2DM) and impaired fasting glucose (IFG) in adulthood.

Materials and methods: This was a 31-year follow-up study of 2300 participants aged 3–18 years. Multinomial logistic regression was used to assess the association of both (a) baseline 25-hydroxyvitamin D (25OHD) levels and (b) the mean of baseline and the latest follow-up 25OHD levels (continuous variable and quartiles) with incident T2DM and IFG (cut-off?=?5.6?mmol/L) in adult life.

Results: High serum 25OHD levels in youth and also mean values from youth to adulthood were associated with reduced risk of developing T2DM in adulthood (odds ratio, 95% confidence interval=?0.73, 0.57–0.95 and 0.65, 0.51–0.84, respectively, for each SD increment in 25OHD). Compared to Q1, a dose-dependent negative association was observed across other quartiles of youth 25OHD, while the strongest association was found in the Q3 for the mean 25OHD levels. Neither youth nor the mean 25OHD was associated with IFG.

Conclusions: High serum 25OHD levels in youth, and from child to adult life, were associated with a reduced risk of developing T2DM in adulthood.

• Key Messages

• High serum 25OHD levels in youth, and between youth and adulthood, were associated with a lower risk of T2DM in adulthood.

• Each SD (15.2?nmol/L) increment in youth serum 25OHD levels was associated with a 26% reduction in odds for T2DM, which was independent of a number of confounding variables and other risk factors for T2DM. A similar magnitude of association was observed for the long-term 25OHD levels between youth and adulthood.

• These findings suggest a potentially simple and cost-effective strategy for reducing adulthood risk of T2DM starting in an earlier stage of life – improving and maintaining vitamin D status throughout youth and early adulthood.

     

2型糖尿病患者糖化血红蛋白及餐后血糖与尿清蛋白排泄率的关系

目的探讨2型糖尿病(T2DM)病人糖化血红蛋白(HBA1c)、餐后2 h血糖(2hPBG)与12 h尿清蛋白排泄率(UAE)的关系。方法选择113例空腹血糖(FBG)控制达标的T2DM患者及54例体检正常人群。HbA1c检测用高效液相色谱法,2 hPBG检测用葡萄糖氧化酶法,尿清蛋白检测用放射免疫法,记录12 h尿量,计算出UAE。按照HbA1c及2 h PBG水平将113例患者分为A组(HbA1c<7%且PBG<10 mmol/L),B组(HbA1c<7%且PBG≥10 mmol/L),C组(HbA1c>7%且PBG<10mmol/L)和D组(HbA1c≥7%且PBG≥10 mmol/L)。结果113例T2DM患者UAE均高于正常对照组(P<0.01)。D组UAE水平明高于A,B,C组(P<0.01,P<0.05,P<0.01);A组UAE水平明显低于C组(P<0.05)。B组与A,C组UAE无差异(P>0.05)。结论T2DM病人FBG控制达标后,餐后血糖及HbA1c控制不良仍会加重尿清蛋白排泄。因此强化血糖控制要重视HbA1c和餐后血糖的监测及达标。     

C肽与糖化血红蛋白、糖化血清蛋白在糖尿病及并发症中的应用

目的 探讨C肽（C-P）、糖化血红蛋白（HbA1c）、糖化血清蛋白（GSP）与空腹血糖（FBD）及餐后2小时血糖（2hBD）水平变化在糖尿病及并发症的诊断和治疗监测中的意义。方法 对148例糖尿病患者和30例正常健康对照者用生化和化学发光免疫方法,进行FBD、空腹C肽（FC-P）、HbAlc、GSP的检测。75 g葡萄糖负荷后,进行2 hBD和餐后2小时C肽（2 hC-P）的检测,以评价胰岛功能变化。结果 在2型糖尿病组和它的几种常见并发症[包括糖尿病视网膜病变（DR）、糖尿病肾病（DN）、糖尿病合并冠心病]的测定中,FC-P、HbAlc、GSP、FBD2、hBD明显高高于健康对照组,其差异有统计学意义（P〈0.01）。这几个项目的升高程度与糖尿病及并发症的严重程度相一致。在糖耐量减退组中,FBD、FC-P和2 hC-P变化不明显（P〉0.05）。2型糖尿病与HbAlc、GSP、FC-P有较好的相关性,相关系数分别为：0.86,0.67,0.89。但2型糖尿病与它的几组并发症之间的检测结果比较,其差异不显著,无统计学意义（P〉0.05）。结论 这几个检测项目与糖尿病和它的并发症有较好的相关性,能从不同方面较客观地反映糖尿病和其并发症患者的病情程度;C-P、HbAlc、GSP水平升高是糖尿病和其并发症发展的危险因素;它们的检测对糖尿病的诊断和治疗监测有较高的价值。     

糖化血红蛋白联合空腹血糖筛查2型糖尿病高危人群的临床意义

目的了解糖化血红蛋白(HbA1c)筛查糖尿病和糖代谢受损的敏感性并与空腹血糖(FBG)进行比较。方法对400例无糖尿病病史的糖尿病高危人群同时检测FBG和HbA1c,据空腹血糖水平分为三组:A1组:FBG<6.1 mmol/L,计336例,A2组:FBG 6.1-6.9 mmol/L,45例,A3组FBG≥7.0 mmol/L,19例。结果 (1)400例人群中,HbA1c≥6.0%,88例,异常率为22.0%;FBG≥6.1mmol/L,54例,异常率13.5.%,HbA1c的异常率高于FBG,P<0.05。(2)A1组HbA1c>≥6.0%,29例,占8.6%;A2组HbA1c≥6.0%,41例,占91.1%;A3组HbA1c≥6.0%,18例,占94.7%;(3)400例人群中,HbA1c≥6.0%或FBG≥6.1mmol/L,93例,异常率23.3%%。结论 HbA1c筛查糖尿病高危人群血糖异常的敏感性高于空腹血糖,两者联合检查有助发现更多糖代谢异常的患者。     

食药材降糖方治疗糖耐量异常及2型糖尿病气阴两虚证的临床效果

目的探讨食药材降糖方治疗糖耐量异常及2型糖尿病气阴两虚证的临床效果。方法选取2019年1月至2019年6月在陕西省中医医院就诊的糖耐量异常(5例)及2型糖尿病气阴两虚证(55例)共计60例患者作为研究对象,给予食药材降糖方治疗。观察临床疗效,比较患者治疗前、后的中医证候积分、血糖指标、血脂指标及胰岛素功能指标,同时对药物安全性进行评价。结果患者临床治疗总有效率为91.67%。治疗后,患者的中医证候积分、HbA1c、HOMA-IR均较治疗前降低,HDL-C水平较治疗前升高,差异具有统计学意义(P<0.05)。患者治疗前、后的FBG、2 h PG、CHO、TG、LDL-C、FINS水平比较,差异无统计学意义(P>0.05)。治疗期间,患者均未发生严重不良反应。结论食药材降糖方对糖耐量异常及2型糖尿病患者可起到辅助降糖作用,能够改善患者的临床症状、HbA1c、HDL-C水平及HOMA-IR。     

2型糖尿病患者血浆甘露聚糖结合凝集素与血糖糖化血红蛋白的相关性分析

目的探讨2型糖尿病(T2DM)患者血浆甘露聚糖结合凝集素(MBL)水平及其与血糖、糖化血红蛋白(HbA1c)的关系。方法选取T2DM患者及健康人各60例,测定血浆MBL、空腹血糖(FPG)和HbA1c水平,观察MBL水平变化及与FPG、HbA1c的关系。结果 T2DM患者血浆MBL、FPG、HbA1c水平均高于健康对照组,差异有统计学意义(P0.01);Pearson相关性分析显示,血浆MBL水平与HbA1c呈明显正相关(r=0.257,P=0.047)。结论 MBL在T2DM患者血浆中明显增高,可能参与了T2DM的发病过程,检测MBL对T2DM的诊断和预后具有潜在的临床价值。