估算的平均血糖 (eAG) 在血糖控制和心血管风险降低中的作用。
Usefulness of estimated average glucose (eAG) in glycemic control and cardiovascular risk reduction.
机构信息
Department of Laboratory Medicine, Dr. Everett Chalmers Regional Hospital, Horizon Health Network, Fredericton, NB, Canada; Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Department of Laboratory Medicine, Dr. Everett Chalmers Regional Hospital, Horizon Health Network, Fredericton, NB, Canada; Department of Pathology, Dalhousie University, Halifax, NS, Canada.
出版信息
Clin Biochem. 2020 Oct;84:45-50. doi: 10.1016/j.clinbiochem.2020.06.009. Epub 2020 Jun 14.
OBJECTIVE
One of the 8 regional health authority (RHA) zones in New Brunswick, Canada has implemented eAG since 2010. We sought to evaluate the clinical outcomes of glycemic control and cardiovascular risk levels before and after the eAG implementation in this zone; and to compare the overall outcomes of this zone with other 7 zones of the province.
METHODS
Data (838,407 HbA1c values and 612,314 LDL-c values) was extracted from all adult diabetic patients in the provincial Diabetes Registry from 2008 to 2014. The Kruskal-Wallis statistic was conducted to compare the medians and inter quartile ranges of HbA1c and LDL-c from different zones. The proportion of patients achieving therapeutic targets, the distribution of HbA1c and LDL-c values pre/post the eAG implementation in RHA Zone 1.1 were assessed by Chi-square analysis.
RESULTS
The proportion of patients achieving targets in Zone 1.1 were at an intermediate level among all 8 zones and the trends of Zone 1.1 were no different than other zones. There were statistically significant differences for Zone 1.1 in the distribution of HbA1c (Z = -12.5190, P < 0.001) and LDL-c (Z = 16.4410, P < 0.001) before and after the eAG reported. The proportion of patients with HbA1c < 53 mmol/mol (7.0%) of the RHA Zone 1.1 was significantly lower after eAG reported (49.85% vs. 47.24%, P < 0.001); while the proportion of patients with LDL-c < 2.6 mmol/L showed statistically significant increase (68.56% vs. 71.90%, P < 0.001).
CONCLUSION
The utilization of eAG has demonstrated no significant impact on glycemic control and cardiovascular risk reduction.
目的
加拿大新不伦瑞克省的 8 个区域卫生局（RHA）之一自 2010 年以来实施了电子病历（eAG）。我们旨在评估该区域实施 eAG 前后血糖控制和心血管风险水平的临床结果，并将该区域的整体结果与该省的其他 7 个区域进行比较。
方法
从 2008 年至 2014 年，从省级糖尿病登记处提取了所有成年糖尿病患者的数据（838407 个 HbA1c 值和 612314 个 LDL-c 值）。采用 Kruskal-Wallis 统计比较不同区域的 HbA1c 和 LDL-c 的中位数和四分位间距。通过卡方检验评估 RHA 区 1.1 实施前后实现治疗目标的患者比例、HbA1c 和 LDL-c 值的分布。
结果
在所有 8 个区域中，Zone 1.1 达到治疗目标的患者比例处于中等水平，且 Zone 1.1 的趋势与其他区域没有不同。在 HbA1c（Z=-12.5190，P<0.001）和 LDL-c（Z=16.4410，P<0.001）的分布方面，Zone 1.1 存在统计学差异。在实施 eAG 报告后，Zone 1.1 的患者中 HbA1c<53mmol/mol（7.0%）的比例显著降低（49.85% vs. 47.24%，P<0.001）；而 LDL-c<2.6mmol/L 的患者比例则显著增加（68.56% vs. 71.90%，P<0.001）。
结论
电子病历的使用并未显示对血糖控制和心血管风险降低有显著影响。
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