Glycated albumin but not HbA1c reflects glycaemic control in patients with neonatal diabetes mellitus
Glycated albumin but not HbA1c reflects glycaemic control in patients with neonatal diabetes mellitus
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DOI：
10.1007/s00125-011-2211-8
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发表时间：
2011-09-01
期刊：
影响因子：
8.2
通讯作者：
Fujieda, K.
中科院分区：
文献类型：
--
作者：
Suzuki, S.;Koga, M.;Fujieda, K.
由于新生儿糖尿病（NDM）患者血液中残留的胎儿血红蛋白（HbF）水平较高，因此很难将HbA（1c）作为新生儿糖尿病（NDM）患者血糖控制的指标。在这项研究中，比较了不受HbF影响的糖化白蛋白（GA）和HbA（1c），以评估它们是否反映了NDM患者的血糖控制情况。这项研究纳入了5名NDM患者。诊断时的年龄为38 ± 20天。所有患者均开始胰岛素治疗，并每月测量GA、HbA（1c）和HbF水平，持续6个月。通过自我血糖监测计算一个月的平均餐前血糖（aPPG）。血糖和GA升高（分别为29.7 +/-13.1 mmol/l [n = 5]和33.3 +/-6.9%[n = 3]），但HbA（1c）在正常范围内（5.4 +/-2.6%[35.5 +/-4.9 mmol/mol]; n = 4）。糖尿病治疗后，aPPG（r =-0.565，p = 0.002）、GA（r =-0.552，p = 0.003）和HbF（r =-0.855，p <0.0001）随年龄增长而降低，而HbA（1c）随年龄增长而升高（r = 0.449，p = 0.004）。GA与aPPG呈强正相关HbA（1c）与aPPG无相关性（r = 0.784，p <0.0001（r = 0.221，p = 0.257），与HbF呈显著负相关（r =-0.539，p = 0.004）AGA是NDM患者中血糖控制的有用指标，而HbA（1c）受HbF的年龄相关变化的影响，不能准确反映血糖控制。
It is difficult to use HbA(1c) as an indicator of glycaemic control in patients with neonatal diabetes mellitus (NDM) because of high levels of fetal haemoglobin (HbF) remaining in the blood. In this study, glycated albumin (GA), which is not affected by HbF, and HbA(1c) were compared to evaluate whether they reflect glycaemic control in patients with NDM.This study included five patients with NDM. Age at diagnosis was 38 +/- 20 days. Insulin therapy was started in all patients, and levels of GA, HbA(1c) and HbF were measured monthly for 6 months. One-month average preprandial plasma glucose (aPPG) was calculated using self-monitoring of blood glucose.Plasma glucose and GA were elevated (29.7 +/- 13.1 mmol/l [n = 5] and 33.3 +/- 6.9% [n = 3], respectively) but HbA(1c) was within normal limits (5.4 +/- 2.6% [35.5 +/- 4.9 mmol/mol]; n = 4) at diagnosis. With diabetes treatment, aPPG (r = -0.565, p = 0.002), GA (r = -0.552, p = 0.003) and HbF (r = -0.855, p < 0.0001) decreased with age, whereas HbA(1c) increased (r = 0.449, p = 0.004). GA was strongly positively correlated with aPPG (r = 0.784, p < 0.0001), while HbA(1c) showed no correlation with aPPG (r = 0.221, p = 0.257) and was significantly inversely correlated with HbF (r = -0.539, p = 0.004).GA is a useful indicator of glycaemic control in patients with NDM, whereas HbA(1c) is influenced by age-related changes in HbF and does not accurately reflect glycaemic control.