评价糖尿病患者住院期间降糖疗效的有效指标——糖化血清白蛋白

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 收集上海交通大学附属第六人民医院内分泌代谢科2006年5月-2007年11月住院的445例2型糖尿病患者,测定空腹血糖(FPG)、餐后2 h血糖(2hPG)、1日指尖血糖谱均值(MBG)、GA、糖化血红蛋白(HbA_1c)等,并对其中101例住院近2周的患者在住院后第12天复查GA、HbA_1c、FPG、2hPG、MBG等指标,其中GA以液态酶法(GA-L)测定.结果 ①445例2型糖尿病患者中,GA与HbA,c(r=0.818)、FPG(r=0.573)、2hPG(r=0.409)、MBG(r=0.313)均呈正相关(P值均<0.01).②101例住院近2周的2型檐尿病患者人院后第12天的GA为(23.24±4.51)%,显著低于人院第1天的(30.10±6.75)%(P<0.01).③101例住院近2周的2型糖尿病患者人院后第12天的GA较入院第1天下降6.86%(P<0.01),平均降幅为21.19%;HbA_1c下降0.74%(P<0.01),平均降幅为6.38%.GA的降幅显著大于HbA_1c(P<0.01).结论 GA可准确、及时地反映短期内平均血糖水平的变化,比HbA_1c更适合作为评价2型糖尿病患者住院期间(12 d)降糖疗效的临床监测指标.

Glycated albumin: an effective marker for assessing glycemic control in diabetic inpatients

Objective To examine the serum glycated albumin (GA) level in diabetic inpatients and to assess its reliability as a clinical marker of short-term blood glucose level and blood glucose control of diabetic inpatients. Methods A total of 445 type 2 diabetic patients, who were treated in our in-patient department from May 2006 to November 2007, were enrolled in the present study. The fasting plasma glucose (FPG), post-prandial plasma glucose (2hPG), GA, and HbA_1c, were observed. The above parameters were measured again on day 12 of hospitalization in 101 patients who were treated for more than two weeks. GA-I technique was used to determine GA. Results ①The GA value was positively correlated with HbA_1c, FPG, 2hPG and MBG, with the coefficients being 0.818, 0.573, 0.409 and 0.313, respectively (P<0.01). ② The GA level in 101 patients was ([23.24±4.51]%) 12 days after admission, significantly lower than that on the first day of admission ([30.10 ± 6.75]%, P<0.01). ③The GA level decreased by 6.86 % in the 101 patients on day 12 of admission compared with that of the pre-treatment level (P<0.01), with a mean cutting down of 21.19%;and the HbA_1c value decreased by 0.74% (P<0.01), with a mean cutting down of 6.38%. The decrease degree of GA was more severe that that of HbA_1c (P < 0.01). Conclusion GA can accurately, promptly reflect the change of mean glycemic level. Compared with HbA_1c, GA is a more suitable clinical monitoring marker for evaluating the glucose control in diabetic inpatients.