Wang Nana, Guo Chuanji, Han Ping, Li Tiegang
Endocrinology Department, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Hospital Administration Office, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Acta Diabetol. 2016 Dec;53(6):973-979. doi: 10.1007/s00592-016-0900-y. Epub 2016 Aug 30.
We investigated associations between serum levels of glycated albumin (GA) and glycated hemoglobin (HbA1c) and the presence of diabetic peripheral neuropathy (DPN) in patients with type 1 diabetes mellitus (T1DM).
Between September 2009 and April 2015, we evaluated 314 patients with T1DM in the Endocrinology Department of Shengjing Hospital of China Medical University. We divided the patients into the DPN group (n = 72) and the non-DPN group (n = 242), on the basis of the presence of DPN.
The DPN group had significantly higher GA values than the non-DPN group. After univariate logistic regression, we selected several factors for further analysis: HbA1c, GA, duration of T1DM, body mass index, smoking, hypertension, and the presence of diabetic complications, including nephropathy, retinopathy, and cardiovascular disease. We performed a multivariate logistic regression analysis to examine the association between the presence of DPN and each of these variables. We identified GA, HbA1c, hypertension, smoking, retinopathy, and cardiovascular disease as independent variables for indicating the presence of DPN. Results of a receiver operating characteristic curve analysis revealed that the area under the curve of GA (0.771) was larger than that of HbA1c (0.629). We defined the cutoff value of GA as 23.5 % (sensitivity 0.764, specificity 0.661) and the cutoff value of HbA1c as 8.45 % (sensitivity 0.667, specificity 0.595) for predicting DPN in patients with T1DM.
GA may be a better indicative marker of DPN in patients with T1DM than HbA1c.
我们研究了1型糖尿病（T1DM）患者血清糖化白蛋白（GA）和糖化血红蛋白（HbA1c）水平与糖尿病周围神经病变（DPN）之间的关联。
2009年9月至2015年4月期间，我们对中国医科大学盛京医院内分泌科的314例T1DM患者进行了评估。根据是否存在DPN，将患者分为DPN组（n = 72）和非DPN组（n = 242）。
DPN组的GA值显著高于非DPN组。单因素逻辑回归分析后，我们选择了几个因素进行进一步分析：HbA1c、GA、T1DM病程、体重指数、吸烟、高血压以及糖尿病并发症（包括肾病、视网膜病变和心血管疾病）的存在情况。我们进行了多因素逻辑回归分析，以检验DPN的存在与这些变量之间的关联。我们确定GA、HbA1c、高血压、吸烟、视网膜病变和心血管疾病是指示DPN存在的独立变量。受试者工作特征曲线分析结果显示，GA的曲线下面积（0.771）大于HbA1c的曲线下面积（0.629）。我们将GA的临界值定义为23.5%（敏感性0.764，特异性0.661），将HbA1c的临界值定义为8.45%（敏感性0.667，特异性0.595），用于预测T1DM患者的DPN。
对于T1DM患者，GA可能是比HbA1c更好的DPN指示标志物。
