Department of Internal Medicine, Aizenbashi Hospital, Osaka, Japan.
Diabetes Care. 2010 Mar;33(3):509-11. doi: 10.2337/dc09-1954. Epub 2009 Dec 23.
OBJECTIVE We have already reported that A1C is elevated because of iron deficiency in late pregnancy among nondiabetic pregnant women. This report examined whether the same phenomenon is observed in pregnant women with diabetes. RESEARCH DESIGN AND METHODS This longitudinal study was conducted in 17 pregnant women with diabetes (20-35 weeks of pregnancy). A1C, serum glycated albumin, erythrocyte indexes, and iron metabolism indexes were measured. RESULTS A1C levels were significantly increased in late pregnancy, whereas serum glycated albumin showed no significant changes. Glycated albumin/A1C ratio, mean corpuscular hemoglobin, serum transferrin saturation, and serum ferritin were significantly decreased in late pregnancy. Serum transferrin saturation showed a significant positive correlation with glycated albumin/A1C ratio. CONCLUSIONS A1C levels, but not serum glycated albumin levels, are elevated in late pregnancy because of iron deficiency in diabetic women. Serum glycated albumin may offer an adequate marker for glycemic control during pregnancy.
我们已经报道过,非糖尿病孕妇在妊娠晚期会因缺铁而导致糖化血红蛋白(A1C)升高。本报告探讨了这一现象是否也发生在糖尿病孕妇中。
本纵向研究纳入了 17 名患有糖尿病的孕妇(妊娠 20-35 周)。检测了 A1C、糖化血清白蛋白、红细胞指标和铁代谢指标。
妊娠晚期 A1C 水平显著升高,而糖化血清白蛋白无明显变化。妊娠晚期糖化白蛋白/A1C 比值、平均红细胞血红蛋白、血清转铁蛋白饱和度和血清铁蛋白显著降低。血清转铁蛋白饱和度与糖化白蛋白/A1C 比值呈显著正相关。
糖尿病孕妇妊娠晚期 A1C 水平升高,而非血清糖化白蛋白水平升高,是由于铁缺乏所致。血清糖化白蛋白可能是妊娠期血糖控制的一个充分标志物。