2型糖尿病患者糖化血红蛋白与慢性并发症的关系

目的探讨2型糖尿病患者糖化血红蛋白（HbAlc）的控制情况及其与糖尿病慢性并发症的关系。方法对80例2型糖尿病及糖尿病伴有慢性并发症患者与60例正常人的糖化血红蛋白（HbAlc）、空腹血糖（FBG）进行比较。结果2型糖尿病患者的HbAlc与FBG呈显著正相关,差异有统计学意义（P〈O．01）。2型糖尿病伴有慢性并发症患者的HbAlc明显高于无并发症者,差异有统计学意义（P％0．01）。结论糖尿病患者慢性并发症的发生与HbAlc有关,HbAlc的控制,对预防糖尿病及其慢性并发症的发生、发展,提高社区糖尿病患者的生活质量都非常重要。     

糖化血红蛋白变异指数与2型糖尿病患者糖尿病慢性并发症的相关性研究

目的 探讨2型糖尿病(T2DM)患者糖化血红蛋白变异指数(HGI)与糖尿病慢性并发症发病的关系.方法 采用整群随机抽样的方法,从常熟市34个乡镇中随机抽出12个乡镇,选取在抽中乡镇登记并纳入国家基本公共卫生服务管理的T2DM患者为研究对象.根据HGI数值,采用三分位数法将患者分为低HGI组、中HGI组和高HGI组,探索...     

糖化血红蛋白检测在糖尿病患者中的应用

目的探讨糖化血红蛋白（HbA1c）检测在糖尿病患者中的应用。方法选择80该院收治的糖尿病患者为观察组,选择同时期在该院进行健康体检的80例体检者为对照组,检测两组的HbA1c、空腹血糖及餐后2h血糖。结果经过检测,观察组的HbA1c、空腹血糖及餐后2h血糖显著高于对照组,差异有统计学意义（P〈0.05）。结论对于糖尿病患者,HbA1c检测优于多次连续血糖测定,是评价长期血糖控制的良好指标,有很高的准确性、敏感性与特异性,对指导临床调整、制订合理的治疗方案有重要临床意义[1]。     

糖尿病患者血浆糖化血红蛋白与微血管并发症的相关性

目的探讨2型糖尿病患者血浆糖化血红蛋白（HbAlc）水平与糖尿病微血管并发症的关系。方法选取本院208例2型糖尿病患者作为研究对象,测定患者空腹血糖血浆糖化血红蛋白（HbAlc）、尿微量白蛋白排泄率,并检查患者视网膜病变情况。统计分析HbAlc水平与患者微血管并发症发生率的关系。结果①208例患者中有眼部视网膜病变者（DR）31例,无视网膜病变（NDR）者177例,DR组HbAlc值为（6．539±1．377）％,NDR组HbAlc值为（5．588±0．577）％,差异有统计学意义（P〈0．05）;随HbAlc水平的升高,DR检出率呈增高趋势。②208例患者中有微量蛋白尿（UMA）的患者27例,无微量蛋白尿（N1mdA）患者181例,UMA组HbAlc值为（6．276±1．191）％,NUMA组HbAlc值为（5．696±0．766）％,差异有统计学意义（P〈0．05）;随HbAlc水平的升高,LIMA检出率呈增高趋势。结论2型糖尿病微血管并发症的发生与患者血浆糖化血红蛋白水平有关,控制糖化血红蛋白对于预防糖尿病微血管并发症有重要的意义。     

探讨2型糖尿病患者空腹血糖及糖化血红蛋白监测意义

目的：本文对笔者所在医院内科125例2型糖尿病患者空腹血糖（FBG）含量和糖化血红蛋白比值（HbAlc）进行分组分析,表明糖化血红蛋白是2型糖尿病诊断新标准和治疗监测的“金标准”,即研究2型糖尿病并发症的控制金指标。方法：采用颗粒增强散射比浊法测定糖化血红蛋白,酶法测定空腹血糖,与正常对照组进行比较。结果：糖尿病轻度组与中度组、重度组血糖、糖化血红蛋白指标比较差异均具有统计学意义（P〈O．01）。结论：测定空腹血糖和糖化血红蛋白对早期诊断糖尿病并发症具有临床意义。     

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。     

2型糖尿病微血管病变患者空腹血糖、糖化血红蛋白检测的临床价值

目的:探讨空腹血糖(FPG)、糖化血红蛋白(HbA1c)在糖尿病微血管病变(DMAP)患者诊断中的临床价值。方法:对176例2型糖尿病患者根据微血管并发症发生情况将其分为三组:无微血管并发症(NDC)组78例,视网膜病变(DR)组59例,糖尿病肾病(DN)组39例,同时检测FPG、HbA1c,并与正常对照组50例比较。结果:176例2型糖尿病各组患者FPG、HbA1c水平明显高于对照组,其中DR组和DN组与对照组比较,差异有非常显著统计学意义(P<0.01),DN组与NDC组比较,差异有非常显著统计学意义(P<0.01)。结论:HbA1c可作为糖尿病患者发现DMAP的一个可靠标,HbA1c测定在糖尿病治疗效果监控,早期预报中老年糖尿病患者微血管病变,阻止或延缓其微血管病变的发生和发展有很重要的意义。     

糖化血红蛋白与糖尿病视网膜病变的关系研究

目的探讨糖化血红蛋白(HbA1C)、空腹血糖(FBG)与2型糖尿病视网膜病变的关系。方法对89例2型糖尿病患者进行HbA1C、FBG检测及眼底检查或荧光素造影检查。其中糖尿病正常眼底(NDR)组49例,糖尿病视网膜病变(DR)组40例。结果 HbA1C水平有糖尿病视网膜病变组较无视网膜病变组高(t=5.310,P0.01),HbA1C水平越高,视网膜病变发生率越高(χ2=12.59,P0.05),HbA1C≥7%时视网膜病变发生率明显升高;而FBG水平DR组与NDR组差异无统计学意义(t=0.438,P0.05)。结论 HbA1C测定可作为DR发生、发展的重要指标,且将HbA1C控制在7%以下,对预防糖尿病视网膜病变的发生和发展极为重要,降低糖化血红蛋白水平有助于降低视网膜病变的危险。     

2型糖尿病患者糖化血红蛋白与血脂的相关性

目的探讨2型糖尿病(T2DM)患者糖化血红蛋白与血脂的关系。方法本文选择2009年1月—2012年1月期间的受试者,对其空腹血糖(FBG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbAlc)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、总胆固醇(TC)的含量进行了检测,并且对其检测结果进行了直线相关性的分析。结果检验组的FBG与HbA1c呈正相关,与TG、TC呈平行升高趋势。结论患者的血脂及糖化血红蛋白的各项检测显示其与DM存在相关性,因而联合检测对于2型糖尿病的诊断有一定临床参考价值。     

糖尿病诊治中糖化血红蛋白与空腹血糖测定的临床意义

目的:比较2010年美国糖尿病协会(ADA)新增糖化血红蛋白(HbA1c)≥6.5%糖尿病(DM)诊断标准和2003年ADA空腹血糖(FPG)≥7.0mol/L的糖尿病诊断标准用于糖尿病诊断的效果。糖尿病筛查的阳性标准与诊断标准相雷同[1]。探讨HbA1c作为诊断标准与FPG水平之间关系。方法:在采用日本奥林巴斯Au640全自动生化分析仪测定HbA1c及空腹血糖(FPG)的含量,抽取住院患者50名,明确诊断糖尿病患者,全部未经治疗。所有病例均符合1999年WHO诊断标准[2]:在空腹12小时,禁饮8小时后检测值进行统计测定。选取在我院体检中心健康体检50人作为检测对象,无特殊病史(无肥胖、肝、肾病史)。结果:HbA1c水平与FPG浓度与正常相关,证明HbA1c水平测定对诊断糖尿病及治疗糖尿病并发症的防治有重要的临床应用价值。     

糖化血红蛋白对妊娠糖尿病的筛查和诊断价值研究

目的探讨糖化血红蛋白(HbAlc)对妊娠糖尿病(GDM)的筛查、诊断的价值。方法 932名足月单胎妊娠初产妇女在孕24～28周常规行75 g口服糖耐量试验(OGTT)和HbAlc检测,分别对照HbAlc各个切点的OGTT结果,观察不同HbAlc切点的诊断敏感性和特异性。结果 HbAlc在5.5%的敏感性为92.73%,特异性为51.43%;在6.0%的敏感性为72.73%,特异性为88.14%;在6.5%的敏感性为49.09%,特异性为99.77%。HbAlc超过5.5%后GDM的检出率即明显增加。如果考虑单个切点的诊断价值,HbAlc在6.0%为较适宜的切点。但在强调早期发现、干预孕期轻度高血糖的治疗新理念下,其作为筛查标准的敏感性不够。HbAlc≤5.5%的孕妇GDM风险低,HbAlc≥6.5%的孕妇极可能为GDM。HbAlc在5.5%～6.5%的孕妇为"HbAlc受损",其GDM发病风险明显增加,须加强孕期监测和管理。结论选择HbAlc在5.5%和6.5%两个切点,保证筛查的高敏感性和诊断的高特异性,可以更好地识别孕期高血糖。     

糖化血红蛋白监测在2型糖尿病患者并发症控制中的意义研究

目的：研究分析糖化血红蛋白（HbA1c）监测在2型糖尿病患者并发症控制中的临床意义。方法：选取2011年11月-2013年2月本院诊治的134例2型糖尿病患者为研究对象,根据HbA1c水平将其分为A组33例（HbA1c＆lt;7.0%）、B组33例（HbA1c7.0%~8.0%）、C组34例（HbA1c8.1%~9.0%）和D组34例（HbA1c＆gt;9.0%）,比较四组患者的并发症发生率,并分析HbA1c与并发症的相关性。结果：D组并发症发生率均高于A组、B组及C组,C组则高于A组和B组,B组高于A组,差异均有统计学意义（P＆lt;0.05）;并发症发生率与HbA1c均有密切的相关性。结论：糖化血红蛋白监测在2型糖尿病患者并发症控制中的临床意义较高,两者之间有密切的关系。     

糖化血红蛋白在筛查妊娠期糖尿病中的临床意义

目的探讨糖化血红蛋白（HbA1c）在妊娠期糖尿病（GDM）诊断中的临床意义。方法收集湖南省妇幼保健院2011年6-9月产前门诊建卡检查孕妇,以《妇产科学》诊断GDM标准,其中正常妊娠50例,产前检查诊断为GDM孕妇74例,妊娠期糖耐量受损孕妇66例。分别检测空腹血糖（FPG）、口服糖负荷试验（OGCT）和HbA1c,并比较各组孕妇三指标的阳性率和敏感度、可靠性、特异度及阳性预测值。结果与正常妊娠组相比,GDM组和糖耐量受损组的GCT及HbA1c水平均显著升高（P〈0.05）;与糖耐量受损组相比,GDM组的GCT及HbA1c水平同样均显著升高（P〈0.05）;GDM组和糖耐量受损组FPG、OGCT、HbA1c诊断阳性率大小顺序为HbA1c〉OGCT〉FPG;GDM筛查中HbA1c敏感性、可靠性、特异性及阳性预测值分别为93.1%、97.9%、98.2%和81.8%,均显著高于FPG、OGCT（P〈0.05）。结论 HbA1c在GDM患者诊断中具有快速,阳性率、敏感性、可靠性和特异性高等特点,在临床GDM诊断中起着重要作用。     

Association Between Different Hemoglobin A1c Levels and Clinical Outcomes Among Elderly Nursing Home Residents With Type 2 Diabetes Mellitus

Objective

New guidelines recommend a target glycated hemoglobin (HbA1c) of 7.5% to 8.0% in elderly persons with type 2 diabetes mellitus (T2DM), but real-world data regarding outcomes associated with different HbA1c levels in the elderly are limited. This study assessed outcomes and their association with defined HbA1c thresholds and age ranges in insulin-treated, elderly, patients with T2DM in long-term care (LTC).

Design

Retrospective analysis of medical charts and the Minimum Data Set (MDS) for the period September 2010 through September 2011.

Setting

A total of 117 nursing homes in the United States.

Participants

Eligible patients had resided in LTC for 3 months or more, had at least 1 full MDS assessment, 2 or more records of insulin dispensing with no pump use, and 1 or more HbA1c measurements.

Measurements

Outcomes that were measured included hypoglycemia, ketoacidosis, infections, falls, hospitalization, and emergency room (ER) visits.

Results

A total of 583 patients were included (mean age 78.9 years, mean chart observation length 55 days). In all groups, hypoglycemia was lowest in patients with an HbA1c level higher than 9.0%. In patients 75 years or older, infection rates were highest when HbA1c levels were higher than 9.0%. Falls increased by HbA1c level in patients aged 65 to 74 years, but decreased by HbA1c levels in patients 85 years or older. Ketoacidosis, hospitalization, and ER visits were low in all groups.

Conclusion

These data suggest that better glycemic levels may not necessarily be associated with better clinical outcomes, and different age groups may exhibit different patterns, thereby supporting the call for individualized glycemic control among elderly patients.     

Habitual Dietary Fiber Intake,Fecal Microbiota,and Hemoglobin A1c Level in Chinese Patients with Type 2 Diabetes

High-fiber diet interventions have been proven to be beneficial for gut microbiota and glycemic control in diabetes patients. However, the effect of a low level of fiber in habitual diets remains unclear. This study aims to examine the associations of habitual dietary fiber intake with gut microbiome profiles among Chinese diabetes patients and identify differential taxa that mediated associations of dietary fiber with HbA1c level. Two cross-sectional studies and one longitudinal study were designed based on two follow-up surveys in a randomized trial conducted during 2015–2017. The study included 356 and 310 participants in the first and second follow-ups, respectively, with 293 participants in common in both surveys. Dietary fiber intake was calculated based on a 3-day 24-h diet recall at each survey and was classified into a lower or a higher group according to the levels taken based on the two surveys using 7.2 g/day as a cut-off value. HbA1c was assayed to assess glycemic status using a cut-off point of 7.0% and 8.0%. Microbiome was profiled by 16S rRNA sequencing. A high habitual dietary fiber intake was associated with a decrease in α-diversity in both the cross-sectional and longitudinal analyses. At the first follow–up, phylum Firmicutes and Fusobacteria were negatively associated with a higher dietary fiber intake (p < 0.05, Q < 0.15); at the second follow-up, genus Adlercreutzia, Prevotella, Ruminococcus, and Desulfovibrio were less abundant in patients taking higher dietary fiber (p < 0.05, Q < 0.15); genus Desulfovibrio and Ruminococcaceae (Unknown), two identified differential taxa by HbA1c level, were negatively associated with dietary fiber intake in both the cross-sectional and longitudinal analyses, and mediated the dietary fiber-HbA1c associations among patients taking dietary fiber ≥ 7.2 g/day (mediation effect β [95%CI]: −0.019 [−0.043, −0.003], p = 0.018 and −0.019 [−0.046, −0.003], p = 0.016). Our results suggest that habitual dietary fiber intake has a beneficial effect on gut microbiota in Chinese diabetes patients. Further studies are needed to confirm our results.     

Associations of Dietary Patterns and Nutrients with Glycated Hemoglobin in Participants with and without Type 1 Diabetes

Background: Diet has been associated with poor glycemic control in diabetes. Few studies have examined this association in people with type 1 diabetes (T1D), who are at a higher risk for cardiovascular disease than people without diabetes. Methods: We report data from cross-sectional and longitudinal analyses from a coronary artery calcification in type 1 diabetes (CACTI) study (n = 1257; T1D: n = 568; non-diabetic controls: n = 689) collected between the years 2000 and 2002. Participants completed a validated food frequency questionnaire, a physical examination, and biochemical analyses. Dietary patterns based on variations in food group intake were created with principal components analysis. Linear regression was used to examine the associations of dietary patterns, macronutrients, and food groups with HbA1c in a model adjusted for relevant covariates and stratified by diabetes status. Results: Three dietary patterns were identified: “fruits, veggies, meats, cereal”, “baked desserts” and “convenience foods and alcohol” patterns. At baseline, a higher intake of the “baked dessert” pattern was significantly associated with higher HbA1c in T1D at baseline as well at year 6 of the study when adjusted for age, sex, BMI, total calories, and diabetes duration. No such associations were observed in the case of non-diabetic controls. Dietary saturated fats and animal fats were also positively associated with HbA1c in adults with T1D at baseline and/or at year 6. Conclusions: The habitual intake of a dietary pattern that is characterized by an increased intake of added sugar and saturated fats, such as in baked desserts, may increase risks of poor glycemic control in T1D.     

2型糖尿病患者幽门螺杆菌感染与糖化血红蛋白的相关性研究

目的探讨2型糖尿病患者幽门螺杆菌感染与糖化血红蛋白的相关性。方法对250例转归明确、资料完整的2型糖尿病患者的幽门螺杆菌感染情况及糖化血红蛋白水平进行回顾性分析,探讨两者的相关性。结果幽门螺杆菌感染阳性率为74．0％,幽门螺杆菌感染阳性患者的糖化血红蛋白水平显著高于幽门螺杆菌阴性患者,幽门螺杆菌感染值与糖化血红蛋白水平呈显著负相关。结论2型糖尿病患者的幽门螺杆菌感染情况与糖化血红蛋白水平呈显著负相关,为临床预防和治疗2型糖尿病提供了新的理论依据。     

自然人群糖尿病空腹血糖和糖化血红蛋白筛查效果评价

目的 评价空腹血糖（FPG）和糖化血红蛋白（HbA1c）在自然人群中糖尿病（DM）的筛查效果,为DM流行病学调查中DM筛查方法的选择提供参考依据。方法 于2010年10-12月采用多阶段分层随机整群抽样方法抽取云南省6个国家级死因登记报告县/区的3 489名≥18岁自然人群进行FPG、服糖后2 h血糖（2hPG）和HbA1c实验室检测,并应用受试者工作特征（ROC）曲线获得FPG、HbA1c与DM的最佳临界点及其灵敏度、特异度和曲线下面积。结果 按照世界卫生组织1999年标准,云南省3 489名≥18岁自然人群中正常血糖、空腹血糖受损（IFG）、糖耐量减低（IGT）和DM者分别为2 975人（85.3%）、230例（6.6%）、176例（5.0%）和108例（3.1%）;FPG诊断DM的最佳临界点为6.4 mmol/L,灵敏度和特异度分别为86.1%和96.5%,曲线下面积为0.926（95%CI=0.887~0.965）,阳性似然比为24.60,阴性似然比为0.14,约登指数为0.83;HbA1c诊断DM的最佳临界点为6.15%,灵敏度和特异度分别为66.7%和87.1%,曲线下面积为0.814（95%CI=0.762~0.867）,阳性似然比为5.18,阴性似然比为0.38,约登指数为0.53。结论 在DM流行病学调查中采用FPG筛查DM效果优于HbA1c。