Gebhart S S, Wheaton R N, Mullins R E, Austin G E
Department of Medicine, Emory University, Atlanta, GA.
Arch Intern Med. 1991 Jun;151(6):1133-7.
We compared four objective measures of glycemic control (fructosamine, total glycated hemoglobin, hemoglobin A1c, and random serum glucose) with home glucose monitoring records in 17 diabetic patients followed up prospectively for 4 months. There was good overall correlation between all of these objective measures and weekly mean capillary glucose values. However, considerable scatter was seen in the data such that none of the glycated protein measurements was an ideal predictor of home glucose values. For example, all markedly elevated home glucose levels (greater than 11.1 mmol/L) were associated with elevated glycated protein levels, but moderately high blood glucose levels (8.3 to 11.1 mmol/L) were associated with one or more normal glycated protein values in some patients. Similar correlations were obtained whether glycemia was estimated by 1-week or 6-week home averages. Random serum glucose level also correlated with average home glucose level; however, there was wide fluctuation within individual subjects. All three glycated protein measurements (hemoglobin A1c, glycated hemoglobin, and fructosamine) appear equally useful as a supplement to home glucose monitoring in the assessment of glycemic control. Of the three types of glycated protein assays, fructosamine, with its advantage of speed and simplicity, may offer a more cost-effective alternative.
我们比较了17例糖尿病患者前瞻性随访4个月期间的四种血糖控制客观指标（果糖胺、总糖化血红蛋白、糖化血红蛋白A1c和随机血糖）与家庭血糖监测记录。所有这些客观指标与每周平均毛细血管血糖值之间总体相关性良好。然而，数据中存在相当大的离散度，以至于没有一种糖化蛋白测量值是家庭血糖值的理想预测指标。例如，所有显著升高的家庭血糖水平（大于11.1 mmol/L）均与糖化蛋白水平升高相关，但在一些患者中，中度高血糖水平（8.3至11.1 mmol/L）与一个或多个正常糖化蛋白值相关。无论血糖是通过1周还是6周的家庭平均值估算，都得到了类似的相关性。随机血糖水平也与家庭平均血糖水平相关；然而，个体受试者之间存在较大波动。在评估血糖控制时，所有三种糖化蛋白测量值（糖化血红蛋白A1c、糖化血红蛋白和果糖胺）作为家庭血糖监测的补充似乎同样有用。在三种糖化蛋白检测类型中，果糖胺具有速度快和操作简单的优点，可能是一种更具成本效益的选择。
