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高甘油三酯血症及其与糖化血红蛋白检测的关联:一项前瞻性对照研究。

Hypertriglyceridemia and Its Association with HbA1c Test: A Prospective Controlled Study.

作者信息

Rodriguez-Gutierrez Rene, Mancillas-Adame Leonardo G, Rodríguez-Tamez Giselle, Diaz Gonzalez-Colmenero Alejandro, Solis-Pacheco Ricardo Cesar, Elizondo-Plazas Ana Sofia, Santos-Santillana Karla M, Gonzalez-Sariñana Linda, Gonzalez-Nava Victoria, Gonzalez-Gonzalez José Gerardo

机构信息

University Hospital "Dr. Jose E. Gonzalez, " Universidad Autonoma de Nuevo Leon, Endocrinology Division, Department of Internal Medicine, Monterrey 64460, Mexico.

Universidad Autonoma de Nuevo Leon, Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit Mexico), Monterrey 64460, Mexico.

出版信息

Int J Endocrinol. 2019 Feb 12;2019:4784313. doi: 10.1155/2019/4784313. eCollection 2019.

Abstract

BACKGROUND

Hypertriglyceridemia and hyperglycemia coexist in 30-60% of patients with diabetes. The impact of hypertriglyceridemia regarding HbA1c assay reliability remains uncertain. Therefore, we conducted a prospective controlled study with the aim of defining the association between triglyceride levels and HbA1c.

METHODS

A total of 44 patients with an index-hospital admission diagnosis of diabetic ketoacidosis or hypertriglyceridemia-induced pancreatitis, as a model for acute elevation of triglycerides, were recruited. Blood samples were drawn for the measurement of HbA1c, triglycerides, glucose, and hemoglobin at baseline and subsequently 24 and 48 hours after admission. HbA1c analysis was performed with high-performance liquid chromatography Bio-Rad D10 (NGSP approved).

RESULTS

All patients completed the study protocol. A difference between mean triglycerides from day 0 (baseline) to day 2 of 1567.2 mg/dL was observed. We found a difference between mean serum HbA1c from days 0 to 2 of 0.09% [1 mmol/mol] ( = 0.004). Moreover, a weak correlation between the mean difference of HbA1c and triglycerides from baseline to day 2 was found to be statistically significant ( = 0.256, = 0.015). None of these findings, however, are clinically significant.

CONCLUSION

Triglycerides do not impair the interpretation of HbA1c assay. Patients and clinicians can now be confident that hypertriglyceridemia is not an important factor when interpreting HbA1c results.

摘要

背景

30% - 60%的糖尿病患者同时存在高甘油三酯血症和高血糖。高甘油三酯血症对糖化血红蛋白(HbA1c)检测可靠性的影响尚不确定。因此,我们开展了一项前瞻性对照研究,旨在明确甘油三酯水平与HbA1c之间的关联。

方法

共招募了44例患者,这些患者因糖尿病酮症酸中毒或高甘油三酯血症性胰腺炎入住我院,以此作为甘油三酯急性升高的模型。在基线时以及入院后24小时和48小时采集血样,用于检测HbA1c、甘油三酯、血糖和血红蛋白。使用经美国国家糖化血红蛋白标准化计划(NGSP)批准的Bio - Rad D10高效液相色谱法进行HbA1c分析。

结果

所有患者均完成了研究方案。观察到从第0天(基线)到第2天平均甘油三酯水平相差1567.2mg/dL。我们发现从第0天到第2天平均血清HbA1c相差0.09%[1mmol/mol](P = 0.004)。此外,从基线到第2天HbA1c的平均差值与甘油三酯之间的弱相关性具有统计学意义(r = 0.256,P = 0.015)。然而,这些发现均无临床意义。

结论

甘油三酯不会影响HbA1c检测结果的解读。患者和临床医生现在可以确信,在解读HbA1c结果时,高甘油三酯血症不是一个重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1446/6390253/db1418e167e7/IJE2019-4784313.001.jpg

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