Guangdong Breath Test Engineering and Technology Research Center, Shenzhen University, Shenzhen, People's Republic of China.
J Breath Res. 2020 Mar 27;14(2):027101. doi: 10.1088/1752-7163/ab75f8.
Glycosylated hemoglobin (HbA1c) is an important criterion for the diagnosis of diabetes and an indicator of the blood glucose level. The red blood cell (RBC) lifespan heterogeneity is sufficient to influence the HbA1c interpretation. In this study, we recruited 120 patients with diabetes mellitus and 85 nondiabetic controls. The HbA1c and the RBC lifespan were detected by high-performance liquid chromatography and the advanced carbon monoxide breath detection method, respectively. Potential correlations of gender and age with HbA1c were analyzed and a receiver operator characteristic curve was generated to get the HbA1c cut-off for every RBC lifespan group. It was confirmed that HbA1c has no correlation with gender or age. The correlation formula between the HbA1c diagnostic criteria and RBC lifespan was derived to correct the HbA1c diagnostic criteria using the least-square method. The RBC-lifespan-corrected HbA1c diagnostic criteria provided 100% sensitivity and specificity for the diagnosis of diabetes in the experimental set and was not refuted in the validated set. The diagnostic value of HbA1c is positively correlated with the RBC lifespan, and four patients with hyperglycemia, whose HbA1c values were lower than the general diagnosis criterion of 6.5%, were still considered to be diabetic according to this formula; that is, the application of this formula may help us to eliminate the 2.2% misdiagnosis rate of the current diagnostic criteria. To provide more accurate detection results, the effect of the RBC lifespan needs to be taken into account when HbA1c is used as a clinical indicator.
糖化血红蛋白（HbA1c）是诊断糖尿病的重要标准，也是血糖水平的指标。红细胞（RBC）寿命的异质性足以影响 HbA1c 的解释。在这项研究中，我们招募了 120 名糖尿病患者和 85 名非糖尿病对照者。HbA1c 和 RBC 寿命分别通过高效液相色谱法和先进的一氧化碳呼气检测法进行检测。分析了性别和年龄与 HbA1c 的潜在相关性，并生成了接受者操作特征曲线，以获得每个 RBC 寿命组的 HbA1c 截止值。证实 HbA1c 与性别或年龄无关。通过最小二乘法推导了 HbA1c 诊断标准与 RBC 寿命之间的相关公式，以校正 HbA1c 诊断标准。使用 RBC 寿命校正的 HbA1c 诊断标准，在实验组中对糖尿病的诊断具有 100%的敏感性和特异性，在验证组中也没有被反驳。HbA1c 的诊断价值与 RBC 寿命呈正相关，根据该公式，有 4 名高血糖患者的 HbA1c 值低于一般诊断标准的 6.5%，仍被认为患有糖尿病；也就是说，该公式的应用可能有助于我们消除当前诊断标准 2.2%的误诊率。为了提供更准确的检测结果，在将 HbA1c 用作临床指标时，需要考虑 RBC 寿命的影响。
