在中国汉族大型人群中，高效液相色谱法测定 HbA1c 和胎儿血红蛋白的性别和年龄差异。

Sex and age discrepancy of HbA1c and fetal hemoglobin determined by HPLC in a large Chinese Han population.

机构信息

Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Department of Endocrinology and Metabolism, The Affiliated Hospital of Nanjing Medical University, Changzhou No. 2 People's Hospital, Changzhou, China.

出版信息

J Diabetes. 2018 Jun;10(6):458-466. doi: 10.1111/1753-0407.12544. Epub 2017 May 14.

DOI:10.1111/1753-0407.12544

PMID:28256058

Abstract

BACKGROUND

It is accepted that HbA1c is an effective indicator to evaluate glycemic control. Fetal hemoglobin (HbF) is seldom measured because traditional detection is inconvenient. In this regard, there may be an advantage in using HPLC autoanalysis of HbA1c as a surrogate method for HbF detection. The aim of the present study was to explore the distribution of HbA1c and HbF in a large Chinese Han population.

METHODS

In all, 70 553 blood samples were collected between January 2012 and June 2016. Study subjects were inpatients undergoing routine medical care and were divided into four groups based on age: Group A, 20-39 years; Group B, 40-59 years; Group C, 60-79 years; and Group D, ≥80 years. Blood HbA1c and HbF concentrations were measured by HPLC using a Tosho Bioscience (Tokyo, Japan) G8 analyzer.

RESULTS

There was a positive association between HbA1c and age, and a negative association between HbF and age. The concentration range of HbF was narrow and HbF concentrations were significantly higher in females than males, regardless of age (median 0.7% vs 0.6%, respectively; P < 0.0001). There was a low degree of correlation between HbF and HbA1c (r = 0.181, P < 0.0001). Although median HbA1c levels were higher in male than female subjects aged 20-59 years (5.5% vs 5.4%, respectively, in Group A; 5.9% vs 5.8%, respectively in Group B), in the 60-79 years group, HbA1c levels were lower in males than females (6.1% vs 6.2%, respectively; P < 0.0001).

CONCLUSIONS

The data suggest that sex and age should be considered in clinical interpretation of HbA1c.

摘要

背景

HbA1c 被认为是评估血糖控制的有效指标。由于传统检测方法不方便，胎儿血红蛋白（HbF）很少被测量。在这方面，使用 HPLC 自动分析 HbA1c 作为 HbF 检测的替代方法可能具有优势。本研究的目的是探讨 HbA1c 和 HbF 在汉族人群中的分布情况。

方法

共收集了 2012 年 1 月至 2016 年 6 月期间的 70553 份血样。研究对象为接受常规医疗护理的住院患者，根据年龄分为 4 组：A 组（20-39 岁）、B 组（40-59 岁）、C 组（60-79 岁）和 D 组（≥80 岁）。采用日本东曹（Tosho Bioscience）G8 分析仪通过 HPLC 测量血 HbA1c 和 HbF 浓度。

结果

HbA1c 与年龄呈正相关，HbF 与年龄呈负相关。HbF 浓度范围较窄，且女性的 HbF 浓度无论年龄大小均显著高于男性（中位数分别为 0.7%和 0.6%；均 P<0.0001）。HbF 与 HbA1c 之间呈低度相关（r=0.181，P<0.0001）。尽管 20-59 岁的男性 HbA1c 水平高于女性（A 组分别为 5.5%和 5.4%；B 组分别为 5.9%和 5.8%），但在 60-79 岁组中，男性的 HbA1c 水平低于女性（分别为 6.1%和 6.2%；均 P<0.0001）。