2 型糖尿病发生过程中糖化血红蛋白和空腹血浆葡萄糖水平的纵向变化轨迹：虎之门医院健康管理中心研究 7（TOPICS 7）。
Longitudinal trajectories of HbA1c and fasting plasma glucose levels during the development of type 2 diabetes: the Toranomon Hospital Health Management Center Study 7 (TOPICS 7).
机构信息
Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan.
出版信息
Diabetes Care. 2012 May;35(5):1050-2. doi: 10.2337/dc11-1793. Epub 2012 Mar 28.
OBJECTIVE
To describe the trajectory of HbA(1c) and glucose concentrations before the diagnosis of diabetes.
RESEARCH DESIGN AND METHODS
The study comprised 1,722 nondiabetic Japanese individuals aged 26-80 years. Fasting plasma glucose (FPG) and HbA(1c) were measured annually for a mean of 9.5 (SD 1.8) years.
RESULTS
Diabetes occurred in 193 individuals (FPG ≥ 7.0 mmol/L, self-reported clinician-diagnosed diabetes, or HbA(1c) ≥ 6.5%). Mean HbA(1c) values were >5.6% each year before diagnosis in diabetes cases. Mean HbA(1c) (5.69% [95% CI 5.50-5.88]) was higher in the 21 individuals who developed diabetes 10 years after the baseline examination than in nondiabetic individuals after 10 years (5.27% [5.25-5.28]). From 3 years to 1 year prediagnosis, HbA(1c) increased 0.09% (SE 0.01)/year, reaching 5.90% (5.84-5.96) 1 year prediagnosis. In the entire group, marked increases in HbA(1c) of 0.3% (SE 0.05%)/year and FPG of 0.63 (0.07) mmol/L/year predicted diabetes.
CONCLUSIONS
HbA(1c) trajectory increased sharply after gradual long-term increases in diabetic individuals.
目的
描述糖尿病诊断前 HbA(1c)和血糖浓度的变化轨迹。
研究设计和方法
本研究纳入了 1722 名年龄在 26-80 岁之间的非糖尿病日本个体。每年测量一次空腹血糖（FPG）和 HbA(1c)，平均随访 9.5（SD 1.8）年。
结果
193 名个体发生了糖尿病（FPG≥7.0mmol/L、自我报告的临床医生诊断的糖尿病或 HbA(1c)≥6.5%）。在糖尿病病例中，诊断前每年的平均 HbA(1c)值均>5.6%。在基线检查后 10 年发生糖尿病的 21 名个体中，平均 HbA(1c)（5.69%[95%CI 5.50-5.88]）高于 10 年后的非糖尿病个体（5.27%[5.25-5.28]）。从 3 年前到诊断前 1 年，HbA(1c)每年增加 0.09%（SE 0.01），达到诊断前 1 年的 5.90%（5.84-5.96）。在整个组中，HbA(1c)每年显著增加 0.3%（SE 0.05%）和 FPG 每年增加 0.63（0.07）mmol/L，可预测糖尿病的发生。
结论
糖尿病个体的 HbA(1c)轨迹在逐渐的长期升高后急剧增加。
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