Oppenheimer Mark, Jensen Richard, Huntington Mark K
Oppenheimer Endocrinology, Sioux Falls, SD, USA.
S D Med. 2013 Feb;66(2):59-61.
Glycohemoglobin level (A1c) is widely viewed as the gold standard for assessing glycemic control. Clinical decisions are based upon it, and reimbursement is increasingly tied to it. However, there are a number of conditions which result in loss of correlation between A1c and mean blood glucose levels. Chronic kidney disease (CKD) is one condition, prevalent as a comorbidity with diabetes, that can result in an inaccurate impression of glycemic control based on measured A1c levels. We review the glycation of hemoglobin, how it is affected in CKD, and review alternative methods for the assessment of glycemic control in these patients.
糖化血红蛋白水平（A1c）被广泛视为评估血糖控制的金标准。临床决策基于此，并且报销也越来越与之挂钩。然而，有多种情况会导致A1c与平均血糖水平之间的相关性丧失。慢性肾脏病（CKD）就是其中一种情况，它作为糖尿病的合并症很常见，会导致基于所测A1c水平对血糖控制产生不准确的判断。我们回顾血红蛋白的糖基化过程、它在CKD中是如何受到影响的，并探讨评估这些患者血糖控制的替代方法。
