糖化血红蛋白A1c的临床应用。
The clinical use of hemoglobin A1c.
作者信息
Saudek Christopher D, Brick Jessica C
机构信息
Johns Hopkins University, Baltimore, Maryland, USA.
出版信息
J Diabetes Sci Technol. 2009 Jul 1;3(4):629-34. doi: 10.1177/193229680900300402.
Hemoglobin A1c (HbA1c) has been accepted as an index of glycemic control since the mid-1970s and is the best marker for diabetic microvascular complications. Clinically, it is now used to assess glycemic control in people with diabetes. Assays are most reliable when certified by the National Hemoglobin Standardization Program but are subject to confounders and effect modifiers, particularly in the setting of hematologic abnormalities. Other measures of chronic glycemic control-fructosamine and 1,5-anhydroglucitol-are far less widely used. The relationship of HbA1c to average blood glucose was intensively studied recently, and it has been proposed that this conversion can be used to report an "estimated average glucose, eAG" in milligrams/deciliter or millimolar units rather than as per cent glycated hemoglobin. Finally, HbA1c has been proposed as a useful method of screening for and diagnosing diabetes.
自20世纪70年代中期以来，糖化血红蛋白（HbA1c）一直被视为血糖控制的指标，并且是糖尿病微血管并发症的最佳标志物。临床上，它现在被用于评估糖尿病患者的血糖控制情况。当通过国家血红蛋白标准化计划认证时，检测结果最为可靠，但这些检测易受混杂因素和效应修饰因素的影响，尤其是在存在血液学异常的情况下。其他慢性血糖控制指标——果糖胺和1,5-脱水葡萄糖醇——的使用则远没有那么广泛。最近对HbA1c与平均血糖之间的关系进行了深入研究，有人提议这种换算可用于报告以毫克/分升或毫摩尔为单位的“估计平均血糖，eAG”，而非糖化血红蛋白百分比。最后，HbA1c已被提议作为筛查和诊断糖尿病的一种有用方法。
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