The Relationships Between Time in Range, Hyperglycemia Metrics, and HbA1c.
The Relationships Between Time in Range, Hyperglycemia Metrics, and HbA1c.
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DOI：
10.1177/1932296818822496
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发表时间：
2019-07-01
影响因子：
5
通讯作者：
Rodbard, David
中科院分区：
文献类型：
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作者：
Beck, Roy W;Bergenstal, Richard M;Rodbard, David
背景：随着连续血糖监测(CGM)的使用增加，有必要更好地了解70-180 mg/dL(TIR70-180)范围内的时间和高血糖的关键指标以及它们与血红蛋白A1c(A1C)的关系。方法：利用四个随机试验的数据集进行分析，这些试验包括545名成年1型糖尿病(T1D)患者，他们在实验室中进行了A1C的中央测量。结果：CGM指标(TIR70-180，Time>；180 mg/dL，Time>；250 mg/dL，平均血糖，曲线下面积180 mg/dL，高血糖指数，时间在70-140 mg/dL)之间的相关性一般为0.90或更高。各指标与A1C的相关性较低(基线绝对值为0.66~0.71，6个月时绝对值为0.73~0.78)。对于给定的TIR70-180百分比，存在与该TIR70-180水平相关的多种可能的A1C水平。平均而言，TIR70-180为70%和50%对应的A1C分别约为7%和8%。对于TIR70-180的特定变化，A1C也有相当大的变化范围，反之亦然。TIR70-180增加10%(每天2.4小时)，A1C平均下降0.6%。结论：在T1D中，反映高血糖(包括TIR和平均血糖)的CGM指标彼此高度相关，但与A1C仅中度相关。对于给定的TIR或TIR中的变化，存在多种可能的对应A1C值。
BACKGROUND: As the use of continuous glucose monitoring (CGM) increases, there is a need to better understand key metrics of time in range 70-180 mg/dL (TIR70-180) and hyperglycemia and how they relate to hemoglobin A1c (A1C).METHODS: Analyses were conducted utilizing datasets from four randomized trials encompassing 545 adults with type 1 diabetes (T1D) who had central-laboratory measurements of A1C. CGM metrics were calculated and compared with each other and A1C cross-sectionally and longitudinally.RESULTS: Correlations among CGM metrics (TIR70-180, time >180 mg/dL, time >250 mg/dL, mean glucose, area under the curve above 180 mg/dL, high blood glucose index, and time in range 70-140 mg/dL) were typically 0.90 or greater. Correlations of each metric with A1C were lower (absolute values 0.66-0.71 at baseline and 0.73-0.78 at month 6). For a given TIR70-180 percentage, there was a wide range of possible A1C levels that could be associated with that TIR70-180 level. On average, a TIR70-180 of 70% and 50% corresponded with an A1C of approximately 7% and 8%, respectively. There also was considerable spread of change in A1C for a given change in TIR70-180, and vice versa. An increase in TIR70-180 of 10% (2.4 hours per day) corresponded to a decrease in A1C of 0.6%, on average.CONCLUSIONS: In T1D, CGM measures reflecting hyperglycemia (including TIR and mean glucose) are highly correlated with each other but only moderately correlated with A1C. For a given TIR or change in TIR there is a wide range of possible corresponding A1C values.