Department of Clinical Biochemistry, Hull Royal Infirmary, Hull, UK;
Clin Chem. 2013 Oct;59(10):1457-60. doi: 10.1373/clinchem.2013.206334. Epub 2013 Jun 21.
Many countries have implemented, or are considering, a change in hemoglobin A1c (Hb A1c) units from traditional percentage values [Diabetes Control and Complications Trial (DCCT)] to the new Système International d'Unités (SI) unit in millimoles per mole. Concern exists that such a large alteration in numeric values might lead, through confusion, to a deterioration in patients' glycemia. This study has assessed Hb A1c in the year before and after the change of units in a UK diabetes population.
The Hb A1c in the 12 months immediately before the unit change (October 2010 to September 2011) was compared with the 12 months after (October 2011 to September 2012). Also, the subsequent change in Hb A1c in patients who had poor glycemic control [Hb A1c >8% (64 mmol/mol)], either before or after the unit change, was compared.
Over the 2 years, 44 721 Hb A1c measurements were requested on 13,197 (7247 male, 5950 female) known diabetes patients. The population Hb A1c was no different between years, with a median [interquartile range (IQR)] value of 7.5% (6.6%-8.7%) after the change and 7.5% (6.5-8.7) before (P = 0.34). The subsequent change in Hb A1c following a raised (>8%) result was the same regardless of whether the initial value reported was in DCCT or SI units [median (IQR) change in Hb A1c -0.2% (-0.9% to 0.3%), n = 4316, following a DCCT result, vs -0.2% (-0.8% to 0.3%), n = 4396, following SI; P = 0.44].
In this UK diabetes population, a move to SI Hb A1c reporting did not lead to any marked short-term deterioration in glycemia or a different Hb A1c outcome in patients with initial poor glucose control.
许多国家已经实施或将考虑将血红蛋白 A1c（Hb A1c）单位从传统的百分比值（糖尿病控制和并发症试验（DCCT））更改为新的国际单位（SI）毫摩尔/摩尔。人们担心，这种数值的巨大变化可能会导致患者血糖恶化，造成混淆。本研究评估了英国糖尿病患者在单位转换前后一年内的 Hb A1c 情况。
将单位转换前的 12 个月（2010 年 10 月至 2011 年 9 月）的 Hb A1c 与转换后的 12 个月（2011 年 10 月至 2012 年 9 月）进行比较。此外，比较了在单位转换前后血糖控制不佳（Hb A1c＞8%（64mmol/mol）的患者的 Hb A1c 随后的变化。
在这 2 年中，对 13197 名（7247 名男性，5950 名女性）已知糖尿病患者的 44721 次 Hb A1c 检测请求进行了分析。转换后，人群的 Hb A1c 没有差异，中位数（四分位距[IQR]）值为 7.5%（6.6%-8.7%），转换前为 7.5%（6.5%-8.7%）（P=0.34）。无论初始值报告的是 DCCT 单位还是 SI 单位，Hb A1c 升高（＞8%）结果后的随后变化均相同[Hb A1c 中位数（IQR）变化-0.2%（-0.9%至 0.3%），n=4316，在 DCCT 结果之后，vs-0.2%（-0.8%至 0.3%），n=4396，在 SI 之后；P=0.44]。
在英国糖尿病患者中，将 SI Hb A1c 报告改为 SI 报告并未导致血糖短期内明显恶化，也未导致初始血糖控制不佳的患者 Hb A1c 结果出现差异。
