Tames F J, Baird J D, Bone A J
Department of Clinical Pathology, Manchester Royal Infirmary, UK.
Diabetologia. 1990 May;33(5):257-61. doi: 10.1007/BF00403317.
Estimations of HbA1 levels have been used to assess long-term glycaemic control in spontaneously diabetic BB/E rats. The degree of metabolic control achieved by once daily insulin injections and continuous insulin infusion by osmotic minipump was compared. Citrate gel electrophoresis of lysed erythrocytes, previously washed and incubated in 0.9% NaCl, gave accurate HbA1 values without interference from either abnormal Hb variants or labile glycosylation products. Over a 12 week period there was no significant difference in the mean random weekly plasma glucose concentrations between diabetic rats maintained on insulin injections or continuous infusion therapy. The HbA1 values in the injection-treated animals remained unchanged throughout the study period (mean +/- SEM = 5.1 +/- 0.1%). Diabetic rats treated by osmotic minipump showed a steady decline in values over the same period (4.1 +/- 0.1%; p less than 0.001 vs injected rats) but levels remained higher than those recorded in non-diabetic control rats (2.9 +/- 0.01%; p less than 0.001 vs pump-treated rats). These differences in HbA1 were reflected in the plasma glucose values obtained during a 30 h glucose profile performed after six weeks of insulin therapy. Diabetic rats on injection therapy showed considerable diurnal variation in plasma glucose concentration (5.5-11.2 mmol/l; mean 8.9 +/- 0.5) but continuous insulin infusion eliminated the fluctuations giving a significantly lower mean glucose level over the 30 h period (7.3 +/- 0.1 mmol/l; p less than 0.005). HbA1 levels show a poor correlation with random plasma glucose estimations (r = 0.43) but provide a simple and accurate assessment of long-term glycaemic control without the need for multiple 24 h glucose profiles.
糖化血红蛋白（HbA1）水平的测定已被用于评估自发性糖尿病BB/E大鼠的长期血糖控制情况。研究比较了每日一次胰岛素注射和通过渗透微型泵持续输注胰岛素所达到的代谢控制程度。对预先洗涤并在0.9%氯化钠中孵育的裂解红细胞进行柠檬酸盐凝胶电泳，可得出准确的HbA1值，不受异常Hb变体或不稳定糖基化产物的干扰。在12周的时间里，接受胰岛素注射或持续输注治疗的糖尿病大鼠每周随机血浆葡萄糖平均浓度没有显著差异。在整个研究期间，注射治疗组动物的HbA1值保持不变（平均值±标准误=5.1±0.1%）。通过渗透微型泵治疗的糖尿病大鼠在同一时期的值呈稳步下降（4.1±0.1%；与注射组大鼠相比，p<0.001），但仍高于非糖尿病对照大鼠的记录水平（2.9±0.01%；与微型泵治疗组大鼠相比，p<0.001）。这些HbA1的差异反映在胰岛素治疗六周后进行的30小时血糖曲线中获得的血浆葡萄糖值上。接受注射治疗的糖尿病大鼠血浆葡萄糖浓度有相当大的昼夜变化（5.5 - 11.2 mmol/L；平均8.9±0.5），但持续胰岛素输注消除了波动，在30小时期间平均葡萄糖水平显著降低（7.3±0.1 mmol/L；p<0.005）。HbA1水平与随机血浆葡萄糖测定的相关性较差（r = 0.43），但无需多次24小时血糖曲线即可提供对长期血糖控制的简单而准确的评估。
