UNEXPLAINED VARIABILITY OF GLYCATED HEMOGLOBIN IN NONDIABETIC SUBJECTS NOT RELATED TO GLYCEMIA
UNEXPLAINED VARIABILITY OF GLYCATED HEMOGLOBIN IN NONDIABETIC SUBJECTS NOT RELATED TO GLYCEMIA
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DOI：
10.1007/bf00404798
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发表时间：
1990-04-01
期刊：
影响因子：
8.2
通讯作者：
GOULD, BJ
中科院分区：
文献类型：
--
作者：
YUDKIN, JS;FORREST, RD;GOULD, BJ
我们研究了在社区研究中筛选的223名40岁以上无已知糖尿病的人的糖化血红蛋白水平。每个人都进行了葡萄糖耐量试验，糖化血红蛋白通过四种方法测定——去除和不去除希夫碱的琼脂凝胶电泳、亲和层析和等电聚焦。2 h血糖与糖化血红蛋白水平的相关系数在0.43 ~ 0.64之间。这种低相关性不能用2小时血糖或糖化血红蛋白的测定或生物学变异来解释。多元回归分析显示，其他糖化血红蛋白测定对任何单一糖化血红蛋白值的差异贡献了0.1%-52.9%（中位数12.8%），而单独用2 h血糖解释的差异为18.6%-41.4%（中位数30.8%），这表明在非糖尿病人群中，葡萄糖耐受不良程度可能只能解释糖化血红蛋白水平差异的三分之一。但是其他因素的作用会导致糖化血红蛋白水平的持续变化。对42例糖化血红蛋白相对于其2小时血糖水平持续高（20例）或低（22例）的受试者的调查显示，年龄、性别、体重指数、血红蛋白水平或吸烟没有差异，尽管50%的低血糖患者糖耐量受损。根据两份五点血糖表估算的环境血糖水平，以及饮食中碳水化合物、淀粉、糖、纤维或酒精的摄入量，都无法解释高血糖和低血糖之间的差异。非糖尿病受试者中糖化血红蛋白水平的个体间一致差异的决定因素仍有待确定。
We have studied levels of glycated haemoglobin in a sample of 223 people aged over 40 years without known diabetes mellitus screened in a community study. Each had a glucose tolerance test and glycated haemoglobin measured by four methods-agar gel electrophoresis with and without removal of Schiff base, affinity chromatography and isoelectric focusing. The correlation coefficients between 2 h blood glucose and levels of glycated haemoglobin were between 0.43 and 0.64. This poor correlation was not explained on the basis of assay or biological variability of either 2 h blood glucose or glycated haemoglobin. Multiple regression analysis showed that other assays of glycated haemoglobin contributed to the variance of any single glycated haemoglobin value by 0.1%-52.9% (median 12.8%) compared to the variance of 18.6%-41.4% (median 30.8%) explained by 2 h blood glucose alone, suggesting that in a non-diabetic population, the degree of glucose intolerance may explain only one third of the variance of glycated haemoglobin levels, but other factors operate to produce consistent changes in levels of glycated haemoglobin. Investigation of 42 subjects with consistently high (20 subjects) or low (22 subjects) levels of glycated haemoglobin relative to their 2 h blood glucose level showed no difference in age, gender, body mass index, haemoglobin levels or smoking, although 50% of low glycators had impaired glucose tolerance. Neither ambient blood-glucose levels, as estimated on two five-point blood-glucose profiles, nor dietary intake of carbohydrate, starch, sugars, fibre or alcohol, explained the difference between high and low glycators. The determinants of the consistent interindividual differences in levels of glycated haemoglobin in non-diabetic subjects remain to be determined.