George Cindy, Matsha Tandi E, Korf Marizna, Zemlin Annalise E, Erasmus Rajiv T, Kengne Andre P
Non-Communicable Diseases Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Cape Town, South Africa.
SAMRC/CPUT/Cardiometabolic Health Research Unit, Department of Biomedical sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa.
BMC Nephrol. 2020 Jan 30;21(1):32. doi: 10.1186/s12882-020-1697-z.
To assess whether the agreement between fasting glucose and glycated proteins is affected by chronic kidney disease (CKD) in a community-based sample of 1621 mixed-ancestry South Africans.
CKD was defined as an estimated glomerular filtration rate < 60 ml/min/1.73 m. Fasting plasma glucose and haemoglobin A1c (HbA1c) concentrations were measured by enzymatic hexokinase method and high-performance liquid chromatography, respectively, with fructosamine and glycated albumin measured by immunoturbidimetry and enzymatic method, respectively.
Of those with CKD (n = 96), 79, 16 and 5% where in stages 3, 4 and 5, respectively. Those with CKD had higher levels of HbA1c (6.2 vs. 5.7%; p < 0.0001), glycated albumin (15.0 vs. 13.0%; p < 0.0001) and fructosamine levels (269.7 vs. 236.4 μmol/l; p < 0.0001), compared to those without CKD. Higher fasting glucose levels were associated with higher HbA1c, glycated albumin and fructosamine, independent of age, gender, and CKD. However, the association with HbA1c and glycated albumin differed by CKD status, at the upper concentrations of the respective markers (interaction term for both: p ≤ 0.095).
Our results suggest that although HbA1c and glycated albumin perform acceptably under conditions of normoglycaemia, these markers correlate less well with blood glucose levels in people with CKD who are not on dialysis.
在一个包含1621名南非混血人群的社区样本中，评估慢性肾脏病（CKD）是否会影响空腹血糖与糖化蛋白之间的一致性。
CKD定义为估算肾小球滤过率<60 ml/min/1.73 m²。空腹血糖采用酶促己糖激酶法测定，糖化血红蛋白（HbA1c）浓度采用高效液相色谱法测定，果糖胺和糖化白蛋白分别采用免疫比浊法和酶法测定。
在患有CKD的人群（n = 96）中，分别有79%、16%和5%处于3期、4期和5期。与无CKD的人群相比，患有CKD的人群HbA1c水平更高（6.2%对5.7%；p < 0.0001）、糖化白蛋白水平更高（15.0%对13.0%；p < 0.0001）以及果糖胺水平更高（269.7对236.4 μmol/l；p < 0.0001）。较高的空腹血糖水平与较高的HbA1c、糖化白蛋白和果糖胺相关，且不受年龄、性别和CKD的影响。然而，在各自标志物的较高浓度下，HbA1c和糖化白蛋白与空腹血糖的相关性因CKD状态而异（两者的交互项：p≤0.095）。
我们的结果表明，尽管HbA1c和糖化白蛋白在血糖正常的情况下表现良好，但在未接受透析的CKD患者中，这些标志物与血糖水平的相关性较差。
