Nuttall Frank Q, Gannon Mary C, Swaim William R, Adams Mary J
Section of endorinology, Metabolism and Nutrition, Veterans Affairs Medical Center, Minneapolis, MN 55417, USA.
Metabolism. 2004 Nov;53(11):1399-404. doi: 10.1016/j.metabol.2004.04.001.
We previously have shown that an affinity, high-performance liquid chromatography (HPLC) method is a highly reproducible and sensitive method for determining percent total glycohemoglobin (tGHb) in people with diabetes. In this study we extended the use of this method to a determination of the correlation of percent tGHb with the fasting plasma glucose concentration in people without known diabetes. We also determined the correlation of the tGHb with the reticulocyte count, as an index of red blood cell (RBC) survival, and with a carbon monoxide (CO) method for determining RBC survival. In addition, the stability of the tGHb, glucose, RBC mass, hemoglobin, and reticulocyte counts over a 1-year period was evaluated. Total glycohemoglobin, overnight fasting plasma glucose concentration, hemoglobin, RBC and reticulocyte count, and the calculated percentage of RBC count represented by reticulocytes were determined monthly for at least 12 months (range, 12 to 26 months) in 48 adults (mean age, 51 years; range, 31 to 82 years). In 37 of the subjects, RBC survival using a CO method also was determined. There was a highly significant linear correlation between the fasting glucose concentration and the tGHb. There was only a weak correlation between the percent reticulocytes or with the RBC survival determined by the CO method. The tGHb, plasma glucose, RBC count, hemoglobin, and percent reticulocytes were very stable over a 12-month or greater period. We conclude that there is a good correlation between the tGHb and plasma glucose concentration in a population without known diabetes. Variations in RBC survival as indicated by a reticulocyte count within the reference range is not likely to have a clinically significant effect on interpretation of tGHb data in the context of an integrated glucose concentration. Nevertheless, this remains to be proven using RBC survival methods that are more precise than those currently available.
我们之前已经表明，亲和高效液相色谱法（HPLC）是一种用于测定糖尿病患者总糖化血红蛋白（tGHb）百分比的高度可重复且灵敏的方法。在本研究中，我们将该方法的应用扩展至测定无糖尿病史人群中tGHb百分比与空腹血糖浓度的相关性。我们还测定了tGHb与网织红细胞计数（作为红细胞（RBC）存活指标）以及与用于测定RBC存活的一氧化碳（CO）方法之间的相关性。此外，评估了tGHb、葡萄糖、RBC数量、血红蛋白和网织红细胞计数在1年期间的稳定性。在48名成年人（平均年龄51岁；范围31至82岁）中，每月测定总糖化血红蛋白、过夜空腹血糖浓度、血红蛋白、RBC和网织红细胞计数，以及由网织红细胞代表的RBC计数的计算百分比，至少持续12个月（范围12至26个月）。在37名受试者中，还使用CO方法测定了RBC存活情况。空腹血糖浓度与tGHb之间存在高度显著的线性相关性。网织红细胞百分比或通过CO方法测定的RBC存活之间仅存在弱相关性。tGHb、血浆葡萄糖、RBC计数、血红蛋白和网织红细胞百分比在12个月或更长时间内非常稳定。我们得出结论，在无糖尿病史人群中，tGHb与血浆葡萄糖浓度之间存在良好的相关性。在参考范围内，网织红细胞计数所表明的RBC存活变化不太可能对综合血糖浓度背景下tGHb数据的解读产生临床显著影响。然而，这仍有待使用比现有方法更精确的RBC存活方法来证实。
