Steno Diabetes Centre, Gentofte, Denmark.
J Clin Endocrinol Metab. 2010 Nov;95(11):E333-6. doi: 10.1210/jc.2010-0710. Epub 2010 Aug 25.
Recently, a change of the diagnostic tool for diabetes from an oral glucose tolerance test (OGTT) to hemoglobin A1c (HbA1c) has been suggested. The aim of the study was to assess whether ethnicity modified the association between glucose levels and HbA1c and to compare diabetes prevalence according to diagnostic method among Greenland Inuit, Inuit migrants in Denmark, and a general Danish population.
Data from two population-based surveys conducted from 1999-2002 were compared with a total of 7957 individuals, 1173 Inuit participants from the Greenland Population Study, including 256 Inuit migrants in Denmark, and 6784 Danish participants in the Inter99 study. The participants received a standard 75-g OGTT. HbA1c was analyzed by an ion-exchange HPLC Bio-Rad variant (Hercules, California). All analyses were performed in the laboratory at Steno Diabetes Centre.
The Inuit had significantly higher levels of HbA1c than the Danish participants at any given level of fasting and 2-h glucose and for each category of glucose tolerance: normal glucose tolerance, impaired fasting glycemia, and impaired glucose tolerance. The prevalence of diabetes diagnosed by OGTT was 11.2% among Inuit residents in Greenland, 9.8% among Inuit migrants, and 4.2% among Danes vs. 31.7% among Inuit residents in Greenland, 21.3% among Inuit migrants, and 6.7% among Danes diagnosed by HbA1c. OGTT-defined diabetes was associated with increased cardiovascular risk factors compared to HbA1c-defined diabetes.
The association between glucose and HbA1c is not the same in the two populations. The mechanism behind this difference is unknown, and studies on long-term consequences associated with HbA1c are needed.
最近，有人建议将糖尿病的诊断工具从口服葡萄糖耐量试验（OGTT）改为糖化血红蛋白（HbA1c）。本研究旨在评估葡萄糖水平与 HbA1c 之间的关联是否因种族而异，并比较格陵兰因纽特人、丹麦因纽特移民和一般丹麦人群中根据不同诊断方法的糖尿病患病率。
将 1999-2002 年进行的两项基于人群的调查的数据与总共 7957 名个体进行了比较，其中包括来自格陵兰人口研究的 1173 名因纽特参与者，包括 256 名在丹麦的因纽特移民和 6784 名丹麦参与者的 Inter99 研究。参与者接受了标准的 75 克 OGTT。HbA1c 通过离子交换 HPLC Bio-Rad 变体（加利福尼亚州赫拉克勒斯）进行分析。所有分析均在 Steno 糖尿病中心的实验室进行。
无论空腹和 2 小时血糖水平如何，以及葡萄糖耐量的每个类别（正常葡萄糖耐量、空腹血糖受损和糖耐量受损），因纽特人的 HbA1c 水平均明显高于丹麦参与者。通过 OGTT 诊断的糖尿病在格陵兰岛的因纽特居民中的患病率为 11.2%，在丹麦的因纽特移民中的患病率为 9.8%，在丹麦人中的患病率为 4.2%，而在格陵兰岛的因纽特居民中的患病率为 31.7%，在丹麦的因纽特移民中的患病率为 21.3%，在丹麦人中的患病率为 6.7%。与 HbA1c 定义的糖尿病相比，OGTT 定义的糖尿病与心血管危险因素增加相关。
在这两个群体中，葡萄糖与 HbA1c 之间的关联并不相同。这种差异的背后机制尚不清楚，需要进行与 HbA1c 相关的长期后果的研究。
