Dezier J F, Barbier P, Le Treut A, Allannic H
Laboratoire de Biochimie Médicale B., Hôpital Sud, Rennes.
Diabete Metab. 1988 Sep-Oct;14(5):635-40.
The authors compared the nycthemeral variations of fructosamine levels in nineteen patients with diabetes to fluctuations in their glucose levels. Thirty-five other patients with poorly controlled diabetes were given an optimal treatment then followed up for 2 months (mean glucose levels, fructosamine and HbA1c assays). Mean nycthemeral variations in fructosamine levels did not appear to be correlated with glucose levels. However, intraindividual nycthemeral variability was greater than the analytic variability. After correction for total protein levels this variability was smaller but remained significative. In this longitudinal study, fructosamine and HbA1c levels decreased when control of glucose levels improved. However, decreases were notably greater in HbA1c than in fructosamine compared at 15, 45 and 60 days of follow up. Inversely, fructosamine was correlated better with the mean glucose levels of the preceding 7 days than was HbA1c. When mean glucose levels were calculated for the 15, 30, 45 and 60 preceding days, the results favored HbA1c. The findings presented in this study show that HbA1c remains the best criteria for monitoring medium term glucose levels. However, further word is needed before this conclusion can be confirmed.
作者比较了19例糖尿病患者果糖胺水平的昼夜变化与其血糖水平的波动情况。另外35例血糖控制不佳的糖尿病患者接受了最佳治疗，随后随访2个月（测定平均血糖水平、果糖胺和糖化血红蛋白）。果糖胺水平的平均昼夜变化似乎与血糖水平无关。然而，个体内昼夜变异性大于分析变异性。校正总蛋白水平后，这种变异性较小但仍具有显著性。在这项纵向研究中，当血糖水平控制改善时，果糖胺和糖化血红蛋白水平下降。然而，在随访的15天、45天和60天时比较，糖化血红蛋白的下降明显大于果糖胺。相反，果糖胺与前7天的平均血糖水平的相关性比糖化血红蛋白更好。当计算前15天、30天、45天和60天的平均血糖水平时，结果更支持糖化血红蛋白。本研究结果表明，糖化血红蛋白仍然是监测中期血糖水平的最佳指标。然而，在证实这一结论之前还需要进一步研究。
