Associations between features of glucose exposure and A1C: the A1C-Derived Average Glucose (ADAG) study.
Associations between features of glucose exposure and A1C: the A1C-Derived Average Glucose (ADAG) study.
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DOI：
10.2337/db09-1774
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发表时间：
2010-07
期刊：
影响因子：
7.7
通讯作者：
ADAG Study Group
中科院分区：
文献类型：
--
作者：
Borg R;Kuenen JC;Carstensen B;Zheng H;Nathan DM;Heine RJ;Nerup J;Borch-Johnsen K;Witte DR;ADAG Study Group
各种方法被用来量化餐后血糖或葡萄糖变异性，但很少有比较，没有一个是标准化的。我们的目的是使用日常生活中获得的详细葡萄糖测量值来检查餐后血糖、总体高血糖、葡萄糖变异性和A1C的常见指标之间的关系，并研究当天的血糖值提供最强的A1C预测。在A1C衍生平均葡萄糖（ADAG）研究中，在16周内通过连续葡萄糖监测（CGM）和频繁自我血糖监测（SMBG）监测了507名参与者（268名1型糖尿病受试者，159名2型糖尿病受试者和80名非糖尿病受试者）的葡萄糖水平。我们计算了几个指标，并分析了它们之间的相关性。采用多元线性回归分析了一天中不同时间（餐前和餐后）血糖测量值与A1C之间的相关性。葡萄糖变异性指标表现出较强的相关性。在餐后指标中，餐后2小时CGM计算的血糖曲线下面积与餐后90分钟SMBG测量值相关性良好。空腹血糖（FBG）水平与高血糖指数和平均或餐后血糖水平仅中度相关。SMBG得出的指数与CGM得出的指数密切相关。某些SMBG时间点与A1C的相关性比其他时间点更强。总体而言，餐前血糖值与A1C的相关性比餐后血糖值更强，尤其是2型糖尿病。葡萄糖变异性指数和平均值以及餐后血糖在每个类别内都有很强的相关性。变异指数与其他类别的相关性较弱，表明这些措施传达不同的信息。FBG并不是一个明确的总体血糖指标。餐前血糖值对A1C水平的影响大于餐后血糖值。
Various methods are used to quantify postprandial glycemia or glucose variability, but few have been compared and none are standardized. Our objective was to examine the relationship among common indexes of postprandial glycemia, overall hyperglycemia, glucose variability, and A1C using detailed glucose measures obtained during everyday life and to study which blood glucose values of the day provide the strongest prediction of A1C. In the A1C-Derived Average Glucose (ADAG) study, glucose levels were monitored in 507 participants (268 type 1 diabetic, 159 type 2 diabetic, and 80 nondiabetic subjects) with continuous glucose monitoring (CGM) and frequent self-monitoring of blood glucose (SMBG) during 16 weeks. We calculated several indexes of glycemia and analyzed their intercorrelations. The association between glucose measurements at different times of the day (pre- and postprandial) and A1C was examined using multiple linear regression. Indexes of glucose variability showed strong intercorrelation. Among postprandial indexes, the area under the glucose curve calculated from CGM 2 h after a meal correlated well with the 90-min SMBG postprandial measurements. Fasting blood glucose (FBG) levels were only moderately correlated with indexes of hyperglycemia and average or postprandial glucose levels. Indexes derived with SMBG strongly correlated with those from CGM. Some SMBG time points had a stronger association with A1C than others. Overall, preprandial glucose values had a stronger association with A1C than postprandial values for both diabetes types, particularly for type 2 diabetes. Indexes of glucose variability and average and postprandial glycemia intercorrelate strongly within each category. Variability indexes are weakly correlated with the other categories, indicating that these measures convey different information. FBG is not a clear indicator of general glycemia. Preprandial glucose values have a larger impact on A1C levels than postprandial values.
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