1 型糖尿病患儿糖化血红蛋白的种族差异独立于平均血糖。
Racial disparity in A1C independent of mean blood glucose in children with type 1 diabetes.
机构信息
Department of Psychology, Children's Hospital, New Orleans, Louisiana, USA.
出版信息
Diabetes Care. 2010 May;33(5):1025-7. doi: 10.2337/dc09-1440. Epub 2010 Feb 25.
Abstract
OBJECTIVE
Mean blood glucose (MBG) and MBG-independent factors both influence A1C levels. Race was related to A1C independent of MBG in adults. The goal of this study was to determine if racial disparity exists in A1C independent of MBG in children with diabetes.
RESEARCH DESIGN AND METHODS
Participants included 276 children with type 1 diabetes. A1C and MBG were obtained from multiple clinic visits, and a hemoglobin glycation index (HGI) (an assessment of A1C levels independent of MBG) was calculated. A1C and HGI were analyzed controlling for age, diabetes duration, and MBG. RESULTS African Americans had statistically significantly higher A1C (9.1 +/- 0.1) and HGI (0.64 +/- 0.11) than Caucasians (A1C 8.3 +/- 0.1, HGI -0.15 +/- 0.07) independent of covariates.
CONCLUSIONS
Because of racial disparity in A1C, which is independent of MBG, we recommend that A1C and MBG be used together to make therapeutic decisions for children with diabetes.
摘要
目的
平均血糖 (MBG) 和 MBG 以外的因素均会影响 A1C 水平。在成年人中，种族与 A1C 独立于 MBG 相关。本研究的目的是确定在儿童糖尿病患者中，是否存在与 MBG 无关的 A1C 种族差异。
研究设计和方法
参与者包括 276 名 1 型糖尿病儿童。从多次就诊中获得 A1C 和 MBG，并计算血红蛋白糖化指数 (HGI)（一种独立于 MBG 评估 A1C 水平的指标）。在控制年龄、糖尿病病程和 MBG 的情况下，对 A1C 和 HGI 进行分析。
结果
非裔美国人的 A1C（9.1 +/- 0.1）和 HGI（0.64 +/- 0.11）明显高于白人（A1C 8.3 +/- 0.1，HGI -0.15 +/- 0.07），独立于协变量。
结论
由于 A1C 存在与 MBG 无关的种族差异，我们建议 A1C 和 MBG 一起用于制定糖尿病儿童的治疗决策。
相似文献
1
Racial disparity in A1C independent of mean blood glucose in children with type 1 diabetes.1 型糖尿病患儿糖化血红蛋白的种族差异独立于平均血糖。
Diabetes Care. 2010 May;33(5):1025-7. doi: 10.2337/dc09-1440. Epub 2010 Feb 25.
2
A labile form of hemoglobin A1c is higher in African-American youth with type 1 diabetes compared to Caucasian patients at similar glucose levels.与血糖水平相似的白人患者相比，1 型糖尿病的非裔美国青少年中血红蛋白 A1c 的不稳定形式更高。
Pediatr Diabetes. 2019 Sep;20(6):736-742. doi: 10.1111/pedi.12863. Epub 2019 Jul 2.
3
Hemoglobin glycation index: a robust measure of hemoglobin A1c bias in pediatric type 1 diabetes patients.糖化血红蛋白指数：评估儿童 1 型糖尿病患者糖化血红蛋白偏差的可靠指标。
Pediatr Diabetes. 2010 Nov;11(7):455-61. doi: 10.1111/j.1399-5448.2009.00630.x.
4
Mean blood glucose-independent HbA1c racial disparity and iron status in youth with Type 1 DM.HbA1c 与种族差异及铁状态在青年 1 型糖尿病患者中呈平均血糖依赖性。
Pediatr Diabetes. 2020 Jun;21(4):615-620. doi: 10.1111/pedi.13002. Epub 2020 Mar 10.
5
Skin intrinsic fluorescence is associated with hemoglobin A(1c )and hemoglobin glycation index but not mean blood glucose in children with type 1 diabetes.皮肤固有荧光与血红蛋白 A(1c)和血红蛋白糖化指数相关，但与 1 型糖尿病患儿的平均血糖无关。
Diabetes Care. 2011 Aug;34(8):1816-20. doi: 10.2337/dc11-0049. Epub 2011 Jun 2.
6
Racial differences in neighborhood disadvantage, inflammation and metabolic control in black and white pediatric type 1 diabetes patients.黑人和白人儿科 1 型糖尿病患者的邻里劣势、炎症和代谢控制的种族差异。
Pediatr Diabetes. 2017 Mar;18(2):120-127. doi: 10.1111/pedi.12361. Epub 2016 Jan 18.
7
Estimated average glucose and self-monitored mean blood glucose are discordant estimates of glycemic control.估算的平均血糖和自我监测的平均血糖是对血糖控制的不一致估计。
Diabetes Care. 2010 Jul;33(7):1449-51. doi: 10.2337/dc09-1498. Epub 2010 Mar 31.
8
Racial disparity in HbA1c persists when fructosamine is used as a surrogate for mean blood glucose in youth with type 1 diabetes.当使用果糖胺作为 1 型糖尿病青少年平均血糖的替代指标时，HbA1c 仍存在种族差异。
Pediatr Diabetes. 2018 Nov;19(7):1243-1248. doi: 10.1111/pedi.12696. Epub 2018 Aug 21.
9
Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels.种族差异与葡萄糖浓度和糖化血红蛋白水平的关系。
Ann Intern Med. 2017 Jul 18;167(2):95-102. doi: 10.7326/M16-2596. Epub 2017 Jun 13.
10
Labile A1C is inversely correlated with the hemoglobin glycation index in children with type 1 diabetes.1 型糖尿病患儿的不稳定糖化血红蛋白与血红蛋白糖化指数呈负相关。
Diabetes Care. 2010 Feb;33(2):273-4. doi: 10.2337/dc08-2220. Epub 2009 Nov 16.
引用本文的文献
1
Disparities in Glycemic Outcomes Persist in Youth with Type 1 Diabetes and High-Technology Use.1型糖尿病青少年和高科技产品使用人群在血糖控制结果上仍存在差异。
Pediatr Diabetes. 2023 Oct 25;2023:6646582. doi: 10.1155/2023/6646582. eCollection 2023.
2
Ethnic disparities in HbA1c and hypoglycemia among youth with type 1 diabetes: beyond access to technology, social deprivation and mean blood glucose.1型糖尿病青少年中糖化血红蛋白和低血糖的种族差异：超越技术获取、社会剥夺和平均血糖水平
BMJ Open Diabetes Res Care. 2025 Jan 25;13(1):e004369. doi: 10.1136/bmjdrc-2024-004369.
3
Importance of the Hemoglobin Glycation Index for Risk of Cardiovascular and Microvascular Complications and Mortality in Individuals with Type 2 Diabetes.血红蛋白糖化指数对 2 型糖尿病个体心血管和微血管并发症及死亡风险的重要性。
Endocrinol Metab (Seoul). 2024 Oct;39(5):732-747. doi: 10.3803/EnM.2024.2001. Epub 2024 Oct 15.
4
Can HbA1c Alone Be Safely Used to Guide Insulin Therapy in African Youth with Type 1 Diabetes?HbA1c 能否单独安全地用于指导非洲青少年 1 型糖尿病患者的胰岛素治疗？
Pediatr Diabetes. 2023;2023. doi: 10.1155/2023/1179830. Epub 2023 Apr 24.
5
Determination of Glucose-Independent Racial Disparity in HbA1c for Youth With Type 1 Diabetes in the Era of Continuous Glucose Monitoring.在持续血糖监测时代确定1型糖尿病青少年糖化血红蛋白中与血糖无关的种族差异。
J Diabetes Sci Technol. 2025 Jan;19(1):72-79. doi: 10.1177/19322968231199113. Epub 2023 Sep 12.
6
Disparities in Hemoglobin A1c Levels in the First Year After Diagnosis Among Youths With Type 1 Diabetes Offered Continuous Glucose Monitoring.接受连续血糖监测的青少年在确诊后第一年的血红蛋白 A1c 水平存在差异。
JAMA Netw Open. 2023 Apr 3;6(4):e238881. doi: 10.1001/jamanetworkopen.2023.8881.
7
Association between hemoglobin glycation index and non-alcoholic fatty liver disease.血红蛋白糖化指数与非酒精性脂肪性肝病的关系。
Front Endocrinol (Lausanne). 2023 Feb 7;14:1094101. doi: 10.3389/fendo.2023.1094101. eCollection 2023.
8
6. Glycemic Targets: Standards of Care in Diabetes-2023.6. 血糖目标：2023 年糖尿病护理标准。
Diabetes Care. 2023 Jan 1;46(Suppl 1):S97-S110. doi: 10.2337/dc23-S006.
9
Glucose-independent racial disparity in HbA1c is evident at onset of type 1 diabetes.1 型糖尿病发病时，HbA1c 存在与葡萄糖无关的种族差异。
J Diabetes Complications. 2022 Aug;36(8):108229. doi: 10.1016/j.jdiacomp.2022.108229. Epub 2022 Jun 8.
10
Examining Indirect Effects of Anxiety on Glycated Hemoglobin via Automatic Negative Thinking and Diabetes-Specific Distress in Adolescents With Type 1 Diabetes.检查青少年 1 型糖尿病患者自动消极思维和糖尿病特定困扰对糖化血红蛋白的间接影响。
Can J Diabetes. 2021 Jul;45(5):473-480. doi: 10.1016/j.jcjd.2021.05.002. Epub 2021 May 11.
本文引用的文献
1
Hemoglobin glycation index: a robust measure of hemoglobin A1c bias in pediatric type 1 diabetes patients.糖化血红蛋白指数：评估儿童 1 型糖尿病患者糖化血红蛋白偏差的可靠指标。
Pediatr Diabetes. 2010 Nov;11(7):455-61. doi: 10.1111/j.1399-5448.2009.00630.x.
2
Racial and ethnic differences in mean plasma glucose, hemoglobin A1c, and 1,5-anhydroglucitol in over 2000 patients with type 2 diabetes.2000多名2型糖尿病患者的平均血糖、糖化血红蛋白和1,5-脱水葡萄糖醇的种族和民族差异。
J Clin Endocrinol Metab. 2009 May;94(5):1689-94. doi: 10.1210/jc.2008-1940. Epub 2009 Mar 10.
3
Elevated A1C in adults without a history of diabetes in the U.S.美国无糖尿病病史成年人的糖化血红蛋白（A1C）升高
Diabetes Care. 2009 May;32(5):828-33. doi: 10.2337/dc08-1699. Epub 2009 Feb 5.
4
Disparities in A1C levels between Hispanic and non-Hispanic white adults with diabetes: a meta-analysis.西班牙裔和非西班牙裔白人糖尿病成年患者糖化血红蛋白（A1C）水平的差异：一项荟萃分析。
Diabetes Care. 2008 Feb;31(2):240-6. doi: 10.2337/dc07-0382. Epub 2007 Oct 31.
5
Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the Diabetes Prevention Program.糖尿病预防计划中糖耐量受损患者的糖化血红蛋白（A1C）在种族和族裔间的差异。
Diabetes Care. 2007 Oct;30(10):2453-7. doi: 10.2337/dc06-2003. Epub 2007 May 29.
6
Disparities in HbA1c levels between African-American and non-Hispanic white adults with diabetes: a meta-analysis.非裔美国糖尿病成年人与非西班牙裔白人糖尿病成年人之间糖化血红蛋白（HbA1c）水平的差异：一项荟萃分析。
Diabetes Care. 2006 Sep;29(9):2130-6. doi: 10.2337/dc05-1973.
7
Mean blood glucose and biological variation have greater influence on HbA1c levels than glucose instability: an analysis of data from the Diabetes Control and Complications Trial.平均血糖和生物学变异对糖化血红蛋白（HbA1c）水平的影响大于血糖不稳定性：糖尿病控制与并发症试验数据分析
Diabetes Care. 2006 Feb;29(2):352-5. doi: 10.2337/diacare.29.02.06.dc05-1594.
8
Biological variation in HbA1c predicts risk of retinopathy and nephropathy in type 1 diabetes.糖化血红蛋白（HbA1c）的生物学变异可预测1型糖尿病患者发生视网膜病变和肾病的风险。
Diabetes Care. 2004 Jun;27(6):1259-64. doi: 10.2337/diacare.27.6.1259.
9
High and low hemoglobin glycation phenotypes in type 1 diabetes: a challenge for interpretation of glycemic control.1型糖尿病中血红蛋白糖化的高低表型：血糖控制解读面临的一项挑战
J Diabetes Complications. 2002 Sep-Oct;16(5):313-20. doi: 10.1016/s1056-8727(01)00227-6.
10
Distribution of HbA(1c) levels for children and young adults in the U.S.: Third National Health and Nutrition Examination Survey.美国儿童和青年成人HbA(1c)水平分布：第三次全国健康与营养检查调查
Diabetes Care. 2002 Aug;25(8):1326-30. doi: 10.2337/diacare.25.8.1326.
Zotero 插件