Hayashi Akinori, Takano Koji, Masaki Tsuguto, Yoshino Sonomi, Ogawa Akifumi, Shichiri Masayoshi
Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine, Kanagawa, Japan.
Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine, Kanagawa, Japan.
J Diabetes Complications. 2016 Nov-Dec;30(8):1494-1499. doi: 10.1016/j.jdiacomp.2016.08.015. Epub 2016 Aug 24.
HbA and glycated albumin (GA) are used to monitor glycemia, but their accuracy to represent glycemic profiles in hemodialysis remains controversial.
Continuous glucose monitoring in 97 patients with type 2 diabetes (41 on hemodialysis [HD] and 56 without nephropathy) was analyzed to evaluate whether HbA and/or GA serve as appropriate glycemic profile markers.
The average glucose significantly correlated with HbA in both HD group and group without nephropathy (r=0.59, P<0.0001; r=0.40, P<0.005). The slopes of linear regression lines were statistically indistinguishable (F=0.30, P=0.744), while the y-intercepts were significantly different (F=57.86, P<0.0001). GA showed strong correlation with the glycemic standard deviation (r=0.68, P<0.0001), and with the average glucose (r=0.42, P<0.001). Least square analysis revealed that only HbA, but not GA, was significantly associated with the average glucose (F=10.20, P<0.0005; F=0.38, P=0.5427), while only GA was significantly associated with the glycemic variability in HD group.
In HD participants, HbA correlates with the average glucose more than GA, but underestimates it, and a correction formula of HbA1c can be developed as an appreciable marker. GA value itself reflects the average glucose, but less accurately than HbA, while it could serve as an indicator for hyperglycemia/hypoglycemia excursion.
糖化血红蛋白（HbA）和糖化白蛋白（GA）用于监测血糖，但它们在血液透析中代表血糖谱的准确性仍存在争议。
分析了97例2型糖尿病患者（41例接受血液透析[HD]，56例无肾病）的连续血糖监测情况，以评估HbA和/或GA是否可作为合适的血糖谱标志物。
HD组和无肾病组的平均血糖与HbA均显著相关（r = 0.59，P < 0.0001；r = 0.40，P < 0.005）。线性回归线的斜率在统计学上无显著差异（F = 0.30，P = 0.744），而截距有显著差异（F = 57.86，P < 0.0001）。GA与血糖标准差显著相关（r = 0.68，P < 0.0001），与平均血糖也显著相关（r = 0.42，P < 0.001）。最小二乘法分析显示，仅HbA与平均血糖显著相关（F = 10.20，P < 0.0005；F = 0.38，P = 0.5427），而在HD组中仅GA与血糖变异性显著相关。
在HD参与者中，HbA与平均血糖的相关性高于GA，但会低估平均血糖，可开发HbA1c的校正公式作为一个合适的标志物。GA值本身反映平均血糖，但准确性低于HbA，而它可作为高血糖/低血糖波动的指标。
