糖化血红蛋白测定对高血压的临床意义

目的探讨糖化血红蛋白A1c(HbA1c)对高血压的诊断价值。方法测定因高血压住院的73例患者的糖耐量试验(OGTT)和HbA1c作为观察组,同时以62例正常人血标本为对照组,OGTT用速率法,HbA1c用微柱层析法。结果观察组[(6.8±1.4)%]与对照组[(5.4±0.6)%]HbA1c水平差异有非常显著意义(P<0.01),观察组中男女性HbA1c水平差异无统计学意义(P>0.05)。结论高血压存在糖代谢紊乱,HbA1c测定对以高血压为首发症状的糖尿病的诊断有良好的指导意义。     

糖化血红蛋白测定对高血压的临床意义

目的 探讨糖化血红蛋白A1c(HbA1c)对高血压的诊断价值.方法 测定因高血压住院的73例患者的糖耐量试验(OGTT)和HbA1c作为观察组,同时以62例正常人血标本为对照组,OGTT用速率法,HbA1c用微柱层析法.结果 观察组[(6.8±1.4)%]与对照组[(5.4±0.6)%]HbA1c水平差异有非常显著意义(P＜0.01),观察组中男女性HbA1c水平差异无统计学意义(P＞0.05).结论 高血压存在糖代谢紊乱,HbA1c测定对以高血压为首发症状的糖尿病的诊断有良好的指导意义.     

高血压患者糖化血红蛋白与颈动脉粥样硬化的关系

目前，糖尿病已被认为是冠心病的等危症，血糖水平与大血管病变之间的关系有可能是连续性的，而不存在一个明显的阈值。糖化血红蛋白能反映过去2～3月内的血糖水平，且检测方便；     

糖化血红蛋白与糖调节受损血糖水平相关性的研究

目的 探讨研究糖化血红蛋白(HbAlc)与糖调节受损血糖水平的相关性.方法 2009年2-3月在兰州大学附属白银医院在岗职工中开展口服75 g葡萄糖耐量试验(OGTT)和HbAlc普查,测定空腹血糖、服糖后2 h血糖及HbAlc,采用葡萄糖氧化酶法测定静脉血浆血糖,采用高效液相色谱分析法测定HbAlc.研究资料纳入标准:空腹血糖<7.0 mmol/L且服糖后2 h血糖<11.1mmol/L者,无糖尿病、血红蛋白病、肝、肾疾患等.进入结果分析的对象共726例,男197例,女529例,平均年龄(39±10)岁.其中正常糖耐量636例(87.6%),糖调节受损90例(12.4%),糖调节受损诊断采用1999年世界卫生组织糖尿病诊断标准.率间比较采用χ~2检验,双变量分析采用Pearson相关分析.结果 (1)糖调节受损占HbAlc≤5.7%人群的2.3%,占HbAlc≥5.8%的人群中89.3%.HbAlc≥5.8%时预测OGTT诊断的糖调节受损状态的敏感度、特异度、阳性预测值、阴性预测值分别为83%、99%、0.89和0.98;(2)OGTT诊断的空腹血糖受损、糖耐量减低及糖调节受损状态的患病率,在HbAlc为5.8%组与5.7%组比较差异具有统计学意义(χ~2值分别为10.077、22.219和27.780,P<0.01或P<0.001);(3)HbAlc水平与空腹血糖受损、糖耐量减低、糖调节受损的患病率之间呈显著性正相关(r值分别为0.957、0.928和0.936,均P<0.01).结论 (1)HbAlc预测糖调节受损与OGTT具有一致性,与OGTT诊断的糖调节受损状态相关的HbAlc最佳临界值为5.8%;(2)HbAlc与OGTT诊断空腹血糖受损、糖耐量减低、糖调节受损状态的血糖水平呈显著性正相关,且HbAlc为5.8%与其相关性极其密切.建议当HbAlc≥5.8%时均应行OGTY检查,以明确有无糖调节受损.     

高血压患者糖化血红蛋白检测的临床价值

目的:探讨高血压患者糖化血红蛋白(HbA1c)检测的临床价值.方法:对699例无糖尿病病史的住院患者,根据有无高血压病史分为高血压组(376例)与非高血压组(323例).所有研究对象均行75 g口服葡萄糖耐量试验(OGTT),检测HbA1c、空腹血糖(FPG)、餐后2h血糖(2h-PPG)、空腹胰岛素(FINS)、血脂...     

糖化血红蛋白与心力衰竭

糖化血红蛋白 A1c(haemoglobinA1c,HbA1c)能回顾性了解受测者近 2～3 个月平均血糖水平。HbA1c 已被临床视为评估糖尿病(DM)患者血糖控制水平的相对金标准,其重要性已在糖尿病治疗领域达到共识。国外已有研究显示 HbA1c 与糖尿病并发心血管疾病有密切联系,HbA1c 在心衰诊治方面亦有其相应价值,本文就 HbA1c 与心力衰竭的关系作一综述。     

老年高血压患者糖化血红蛋白水平与颈动脉粥样硬化的相关性

<正>糖化血红蛋白(Hb A1c)是血红蛋白中糖基化的部分,作为糖尿病的诊断和治疗推荐指标之一,生理条件下的非酶促的糖基化过程是否可能导致动脉血管内皮的损害而造成早期的颈动脉内膜中层厚度(CIMT)增厚并导致以后的动脉粥样斑块的发生。本研究观察老年高血压患者Hb A1c水平与颈动脉粥样硬化相关性。1对象和方法1.1对象2007~2009年内分泌科、心内科和高血压科住院     

糖化血红蛋白切点和糖调节异常的相关性研究

目的探讨HbAlc的可能切点和糖调节异常的相关性。方法江苏地区既往无糖尿病、具有糖尿病高危因素而接受筛查的受检者397名,男217名,女180名,行口服葡萄糖耐量试验（OGTT）,同时测定HbAlc。采用受试者工作特征曲线（ROC曲线）进行判断,以OGTT诊断糖尿病时HbAlc对应的可能切点。结果根据2004年美国糖尿病学会（ADA）的糖尿病诊断标准,本研究人群糖尿病233例,空腹血糖受损（IFG）24例,糖耐量受损（IGT）40例,糖调节异常（IGR）62例,糖耐量正常（NGT）38例。ROC曲线提示,以HbAlc作为诊断糖尿病的切点为6．1％（敏感性80．25％,特异性71．30％）;以FBG≥6．3mmol/L或HbAlc≥6．1％作为诊断糖尿病的敏感性和特异性分别为91．85％和59．76％;以FBG≥6．3mmol/L且HbAlc≥6．1％诊断糖尿病的敏感性和特异性分别为60．52％和89．63％。结论FBG≥6．3mmol/L或HbAlc≥6．1％者仍应行OGTF以明确是否患有糖尿病。     

糖化血红蛋白与冠心病的相关性研究

糖尿病是冠心病的等危症[1],耱化血红蛋白Alc是衡量血糖控制与否的金标准[2].现就糖化血红蛋白Alc与冠心痛关系的相关研究进展作一综述.     

平均血糖能否替代糖化血红蛋白

糖化血红蛋白(HbA1c)是血红蛋白在高血糖作用下发生缓慢连续的非酶促糖化反应的产物,反映的是2～3个月内的平均血糖,是最重要的长期血糖控制情况的监测指标。由于HbA1c检测方法众多,为减少了各实验室之间的差异,美国、日本、瑞典分别提出自己的HbA1c标准化检测方法,但这些检验方法均为非特异性的。2007年国际临床化学与实验医学联合会(IFCC)研发了检测HbA1c的全新方法,该方法为高度特异性检验,导致HbA1c检测值偏低。为避免新旧HbA1c检测参考值发生混淆,因此美国糖尿病学会(ADA)、欧洲糖尿病研究学会(EASD)、国际糖尿病联盟(IDF)的HbA1c检测工作小组建议采用平均血糖(AG)表示HbA1c。本文综述了AG代替HbA1c的由來、HbA1c与AG的关系、国际多中心ADAG研究与启示,并讨论了今后的发展方向。     

老年2型糖尿病患者糖化白蛋白及糖化血红蛋白与血糖波动的相关性

目的：分析住院老年2型糖尿病患者糖化血清白蛋白（GA）、糖化血红蛋白（HbA1c）与平均血糖波动幅度（MAGE）、血糖标准差（SDBG）的相关性,为临床全面评价GA和HbA1c提供理论依据。方法研究对象来源于上海交通大学附属第六人民医院内分泌代谢科2013年2月至2014年2月住院的660例老年2型糖尿病患者,入院后第2天测定静脉空腹血糖（FPG）、HbA1c、GA、空腹C肽（FCP）及餐后2h血糖（2hPBG）、餐后2hC肽（2hCP）等。采用动态血糖监测系统（CGMS）对研究对象进行连续3d的血糖监测。采用MAGE和SDBG评估研究对象的血糖波动程度,采用CGM中连续48h的平均血糖水平（MBG）评估整体血糖水平。结果（1）660例研究对象中男346例、女314例。年龄（66±6）岁,糖尿病病程[8.0（4.0～13.8）]年,HbA1c为[8.2（6.7～9.6）]%,GA为[21.1（17.6～25.9）]%,MAGE为[5.3（3.9～7.2）]mmol/L,SDBG为[2.1（1.6～2.7）]mmol/L,MBG为[8.6（7.3～10.1）]mmol/L。（2）单相关分析GA与HbA1c之间有良好的相关性（r＝0.836,P＜0.01）。GA与FPG、2hPBG、MBG呈正相关（r分别为0.604,0.670,0.650,均P＜0.01）;HbA1c与FPG、2hPBG、MBG呈正相关（r分别为0.603,0.634,0.661,均P＜0.01）。（3）单相关分析GA与MAGE、SDBG呈正相关（r分别为0.485,0.529,均P＜0.01）;HbA1c与MAGE、SDBG呈正相关（r分别为0.417、0.495,均P＜0.01）。（4）逐步多元回归分析显示,GA水平与血糖波动参数MAGE和SDBG水平独立相关。结论与HbA1c相比,GA能更好地反映餐后血糖的水平及血糖的波动情况。     

Utility of hemoglobin A1c in predicting diabetes risk

BACKGROUND: There is controversy surrounding the issue of whether, and how, to screen adults for type 2 diabetes. Our objective was to measure the incidence of new diabetes among outpatients enrolled in a health care system, and to determine whether hemoglobin A1c (HbA1c) values would allow risk stratification for patients' likelihood of developing diabetes over 3 years. METHODS: We conducted a prospective cohort study with 3-year follow-up at a single large, tertiary care, Department of Veterans Affairs Medical Center (VAMC). A convenience sample of 1,253 outpatients without diabetes, age 45 to 64, with a scheduled visit at the VAMC, were screened for diabetes using an initial HbA1c measurement. All subjects with HbA1c > or = 6.0% (normal, 4.0% to 6.0%) were invited for follow-up fasting plasma glucose (FPG). We then surveyed patients annually for 3 years to ascertain interval diagnosis of diabetes by a physician. The baseline screening process was repeated 3 years after initial screening. After the baseline screening, new cases of diabetes were defined as either the self-report of a physician's diagnosis of diabetes, or by HbA1c > or = 7.0% or FPG > or = 7.0 mmol/L at 3-year follow-up. The incidence of diabetes was calculated as the number of new cases per person-year of follow-up. RESULTS: One thousand two hundred fifty-three patients were screened initially, and 56 (4.5%) were found to have prevalent unrecognized diabetes at baseline. The 1,197 patients without diabetes at baseline accrued 3,257 person-years of follow-up. There were 73 new cases of diabetes over 3 years of follow-up, with an annual incidence of 2.2% (95% confidence interval [CI], 1.7% to 2.7%). In a multivariable logistic regression model, baseline HbA1c and baseline body mass index (BMI) were the only significant predictors of new onset diabetes, with HbA1c having a greater effect than BMI. The annual incidence of diabetes for patients with baseline HbA1c < or = 5.5 was 0.8% (CI, 0.4% to 1.2%); for HbA1c 5.6 to 6.0, 2.5% (CI, 1.6% to 3.5%); and for HbA1c 6.1 to 6.9, 7.8% (CI, 5.2% to 10.4%). Obese patients with HbA1c 5.6 to 6.0 had an annual incidence of diabetes of 4.1% (CI, 2.2% to 6.0%). CONCLUSIONS: HbA1c testing helps predict the likelihood that patients will develop diabetes in the future. Patients with normal HbA1c have a low incidence of diabetes and may not require rescreening in 3 years. However, patients with elevated HbA1c who do not have diabetes may need more careful follow-up and possibly aggressive treatment to reduce the risk of diabetes. Patients with high-normal HbA1c may require follow-up sooner than 3 years, especially if they are significantly overweight or obese. This predictive value suggests that HbA1c may be a useful test for periodic diabetes screening.     

Clinical Advances in Hemoglobin A1c Measurement: The Clinical Use of Hemoglobin A1c

Hemoglobin A1c (HbA1c) has been accepted as an index of glycemic control since the mid-1970s and is the best marker for diabetic microvascular complications. Clinically, it is now used to assess glycemic control in people with diabetes. Assays are most reliable when certified by the National Hemoglobin Standardization Program but are subject to confounders and effect modifiers, particularly in the setting of hematologic abnormalities. Other measures of chronic glycemic control—fructosamine and 1,5-anhydroglucitol—are far less widely used. The relationship of HbA1c to average blood glucose was intensively studied recently, and it has been proposed that this conversion can be used to report an “estimated average glucose, eAG” in milligrams/deciliter or millimolar units rather than as per cent glycated hemoglobin. Finally, HbA1c has been proposed as a useful method of screening for and diagnosing diabetes.     

Laboratory Advances in Hemoglobin A1c Measurement: The Correlation of Hemoglobin A1c to Blood Glucose

The understanding that hemoglobin A1c (HbA1c) represents the average blood glucose level of patients over the previous 120 days underlies the current management of diabetes. Even in making such a statement, we speak of “average blood glucose” as though “blood glucose” were itself a simple idea. When we consider all the blood glucose forms—arterial versus venous versus capillary, whole blood versus serum versus fluoride-preserved plasma, fasting versus nonfasting—we can start to see that this is not a simple issue.Nevertheless, it seems as though HbA1c correlates to any single glucose measurement. Having more than one measurement and taking those measurements in the preceding month improves the correlation further. In particular, by having glucose measurements that reflect both the relatively lower overnight glucose levels and measurements that reflect the postprandial peaks improves not only our ability to manage diabetes patients, but also our understanding of how HbA1c levels are determined. Modern continuous glucose monitoring (CGM) devices may take thousands of glucose results over a week. Several studies have shown that CGM glucose averages account for the vast proportion of the variation of HbA1c.The ability to relate HbA1c to average glucose may become a popular method for reporting HbA1c, eliminating current concerns regarding differences in HbA1c standardization. Hemoglobin A1c expressed as an average glucose may be more understandable to patients and improve not only their understanding, but also their ability to improve their diabetes management.     

GHbA1c和hsCRP与高血压患者颈动脉粥样硬化程度的关系

目的 研究糖化血红蛋白A1c(glycosylated hemoglobin A1c,GHbA1c)和高敏C反应蛋白(highsensitivity reactive protein C,hsCRP)与原发性高血压患者颈动脉粥样硬化程度的关系.方法 对152例原发性高血压3级患者进行颈动脉超声检查,并检测GHbA1c和hsCRP.按不同颈动脉超声结果分组后比较各组的CHbA1c和hsCRP乘积.结果 颈动脉超声检查结果合并颈动脉内膜增厚,尤其合并颈动脉斑块形成的原发性高血压患者血清hsCRP和HbA1c的乘积显著高于无颈动脉内膜增厚患者(F=8.893,P=0.001):血清hsCRP和HbA1c的乘积与原发性高血压患者颈动脉粥样硬化(IMT增厚或斑块形成)呈正相关(r=0.459,P=0.001).结论 糖耐量异常和炎症反应的联合作用,加重了原发性高血压患者动脉粥样硬化的程度.     

中国人群平均血糖与糖化血红蛋白转换关系的初步分析

目的 采用动态血糖监测（CGM）技术探讨不同糖代谢人群24 h平均血糖水平（MBG）与糖化血红蛋白（HbA1c）的关系,并初步建立不同HbA1c水平其相对应的MBG值.方法 选取2007年8月至2010年1月于上海交通大学附属第六人民医院门诊及病房进行口服葡萄糖耐量试验（OGTT）的受试者318人,其中正常糖调节组115名、糖调节受损组57例、新诊断2型糖尿病患者组146例.糖尿病、糖调节受损的诊断采用2003年美国糖尿病学会（ADA）糖尿病诊断标准.测量各组生化指标,并行OGTT,测定糖负荷后2 h血糖（2 h PG）.采用CGM系统估算MBG水平,高压液相法测定HbA1c水平,分析MBG与HbA1c间的关系.统计学采用单因素ANOVA方差分析、Kruskal-Wallis检验、χ^2检验、Spearman相关分析及线性模型进行数据统计.结果 318例研究对象中总体HbA1c水平为（6.6±1.5）%,MBG水平为（7.3±2.3）mmol/L.（2）MBG与HbA1c呈显著正相关（r=0.848,P〈0.01）,其回归方程为MBG=1.252×HbA1c-0.992（R^2= 0.718,P〈0.01）,即HbA1c每升高1%,MBG相应升高1.252 mmol/L.HbA1c=6.5%时,对应的MBG值为7.1 mmol/L.HbA1c=7.0%时,对应的MBG值为7.8 mmol/L.（3）仅包括146例新诊断2型糖尿病患者的MBG和HbA1c之间的关系与总人群的结果一致（r=0.788,P〈0.01）,线性回归方程为MBG=1.255×HbA1c-0.886（R2=0.621,P〈0.01）.当HbA1c= 6.5%时,MBG对应值为7.3 mmol/L.HbA1c=7.0%时,对应的MBG值为7.9 mmol/L.结论 初步建立了各HbA1c水平其相应的MBG值,为深入开展中国人群平均血糖与HbA1c转换关系研究提供了线索.     

2型糖尿病患者糖化血红蛋白水平与内皮功能评估指数的相关性

目的 探讨糖化血红蛋白(HbA1c)与反应性充血指数(RHI)的相关性.方法 入选2017年1月至2019年2月南京医科大学第一附属医院内分泌科收治的2型糖尿病患者608例,住院期间所有患者均使用Endo-PAT无创血管内皮功能检测技术计算出评估指数RHI.根据RHI结果分组,RHI≥1.67为对照组,RHI<1.67...