糖化白蛋白、糖化血红蛋白及其比值在新诊断2型糖尿病患者降糖过程中的变化

目的探讨糖化白蛋白(GA)、糖化血红蛋白(HbA1c)及其比值(GA/HbA1c)在新诊断2型糖尿病(T2DM)患者降糖过程中变化。方法以70例内分泌科门诊和住院的新诊断T2DM患者为研究对象。所有患者均单服二甲双胍治疗24周,并于服药前、每服药4周后取空腹静脉血检测GA和HbA1c。结果GA在第8周时从基础值(26.1±8.3)%下降至最低值(17.3±4.5)%,差异有统计学意义(P0.01),HbA1c则在第16周时从基础值(10.1±2.4)%下降至最低值(7.5±1.0)%,差异有统计学意义(P0.01)。GA/HbA1c比值在第8周时从基础值(2.58±0.35)下降为最低值(2.06±0.24),差异有统计学意义(P0.001),后在第16周时又上升为(2.31±0.31),但仍低于基础值,差异有统计学意义(P0.01)。整个治疗期间GA/HbA1c值的变化(△GA/HbA1c)与基础HbA1c(r=-0.657,P=0.008)、GA(r=-0.702,P=0.002)呈负相关而与△GA呈正相关(r=0.813,P0.001),与△HbA1c无相关性。结论在新诊断的T2DM患者降糖过程中,GA/HbA1c可能比GA或HbA1c更能反映血糖控制效果。

Changes of the glycated albumin,glycated haemoglobin,and their ratio in newly diagnosed patients with type 2 diabetes

Objective To explore the changes of the glycated albumin (GA ) ,glycated haemoglobin (HbA1c) ,and their ratio (GA/HbA1c) in newly diagnosed patients with type 2 diabetes mellitus (T2DM ) .Methods Seventy inpatients and outpatients with newly diagnosed T2DM in the hospital were selected .All the patients were treated with metformin for 24 weeks .GA and HbA1c were measured before treatment and every four weeks after treatment .Results The level of GA decreased from (26 .1 ± 8 .3)% at baseline to the lowest value (17 .3 ± 4 .5)% ] at eighth week after treatment ,the difference had statistical significance (P<0 .01) ,and the level of HbA1c decreased from (10 .1 ± 2 .4)% at baseline to (7 .5 ± 1 .0)% at 16th week ,the difference was statistically significant (P<0 .01) .The level of GA/HbA1c decreased from (2 .58 ± 0 .35) at baseline to the (2 .06 ± 0 .24) at eighth week ,however ,the ratio increased from (2 .06 ± 0 .24) at eighth week to (2 .31 ± 0 .31) at 16th week ,the differences were all statistically significant (P<0 .001) .Although the GA/HbA1c ratio at 16th week and 24th were significantly lower than that at baseline (P<0 .01) .The change of the GA/HbA1c ratio during 24 weeks (△GA/HbA1c) was negatively correlated with both HbA1c (r= -0 .657 ,P=0 .008) and GA (r= -0 .702 ,P=0 .002) at baseline .Moreover ,the △GA/HbA1c was positively correla‐ted with △GA (r=0 .813 ,P<0 .001) during 24 weeks ,but △GA/HbA1c was not correlated with △HbA1c .Conclusion In newly diagnosed patients with T2DM ,the GA/HbA1c ratio may be better than GA or HbA1c in reflecting the effect of hypoglycemic when the patients are treated with metformin .