Godbout A, Hammana I, Potvin S, Mainville D, Rakel A, Berthiaume Y, Chiasson J-L, Coderre L, Rabasa-Lhoret R
Endocrinology Division, Department of Medicine, centre hospitalier de l'université de Montréal, Montréal, Québec, Canada.
Diabetes Metab. 2008 Dec;34(6 Pt 1):568-73. doi: 10.1016/j.diabet.2008.05.010. Epub 2008 Oct 14.
Cystic fibrosis-related diabetes (CFRD) prevalence has increased dramatically with the improved life expectancy of patients with cystic fibrosis (CF). Glycated haemoglobin (HbA(1c)) is an important tool for monitoring blood glucose control but, unlike in type 1 and type 2 diabetes, a correlation between HbA(1c), fructosamine and mean plasma glucose has not been clearly established in CF. This study aimed to examine the relationship between mean plasma glucose and HbA(1c) or fructosamine in stable patients with CFRD.
Fifteen type 1 diabetes and 13 CFRD patients (HbA(1c)<9.0%; no anaemia), matched for age and body mass index (BMI), provided 72 capillary blood glucose profiles taken 3days/month for three months. At the end of this time, HbA(1c) and fructosamine were measured. Mean plasma glucose was estimated using the Diabetes Control and Complications Trial (DCCT) conversion formula, and linear regressions carried out to establish its relationship with HbA(1c) and fructosamine.
In type 1 diabetes patients, mean plasma glucose correlated significantly with HbA(1c) (r=0.68; P=0.005). In CFRD patients, no correlation was found between mean plasma glucose and HbA(1c) (r=0.24; P=0.460). Also, no association was found between mean plasma glucose, representing the month before blood sampling, and fructosamine in either group.
Unlike in type 1 diabetes, HbA(1c) did not correlate with mean plasma glucose in CFRD subjects. Thus, having a normal HbA(1c) may not be sufficient to indicate a low risk of diabetes complications in CFRD. Further studies are required to explain such a discrepancy.
随着囊性纤维化（CF）患者预期寿命的提高，囊性纤维化相关糖尿病（CFRD）的患病率急剧上升。糖化血红蛋白（HbA1c）是监测血糖控制的重要工具，但与1型和2型糖尿病不同，CF患者中HbA1c、果糖胺与平均血糖之间的相关性尚未明确确立。本研究旨在探讨稳定的CFRD患者平均血糖与HbA1c或果糖胺之间的关系。
15例1型糖尿病患者和13例CFRD患者（HbA1c<9.0%；无贫血），年龄和体重指数（BMI）匹配，连续三个月每月3天提供72份毛细血管血糖谱。在此期间结束时，测量HbA1c和果糖胺。使用糖尿病控制与并发症试验（DCCT）转换公式估算平均血糖，并进行线性回归以确定其与HbA1c和果糖胺的关系。
在1型糖尿病患者中，平均血糖与HbA1c显著相关（r=0.68；P=0.005）。在CFRD患者中，未发现平均血糖与HbA1c之间存在相关性（r=0.24；P=0.460）。此外，两组中代表采血前一个月的平均血糖与果糖胺之间均未发现关联。
与1型糖尿病不同，CFRD患者中HbA1c与平均血糖不相关。因此，HbA1c正常可能不足以表明CFRD患者发生糖尿病并发症的风险较低。需要进一步研究来解释这种差异。
