Mahgoob Mohammed Hashem, Moussa Mahmoud Mohammed
Department of Pediatrics, Faculty of Medicine, Minia University, Minia, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Minia University, Minia, Egypt.
Clin Pediatr Endocrinol. 2020;29(4):151-157. doi: 10.1297/cpe.29.151. Epub 2020 Oct 3.
We evaluated the clinical usefulness of glycated albumin (GA) and glycated hemoglobin (HbA1c) as indicators of glycemic control in type I diabetic (T1DM) children with and without iron deficiency anemia (IDA). Our prospective cross-sectional study was conducted on 147 T1DM children who were classified into Group I (with IDA) and Group II (without anemia). The participants were classified as controlled and uncontrolled based on mean blood glucose (MBG) in the past 30 days. The 5-12-yr-olds with MBG above 200 and 12-15-yr-olds with levels above 180 md/dl were considered uncontrolled. HbA1c increased significantly in the participants with IDA compared to those without anemia (p < 0.01). HbA1c in those with IDA showed insignificant difference between the controlled and uncontrolled (p = 0.5), while GA was significantly higher in the uncontrolled than the controlled (p = 0.3). Receiver operating characteristic (ROC) curve analysis showed that GA had 87.2% sensitivity and 75.8% specificity at a cut-off point of 16.9%. HbA1c at a cut-off point of 7.09% showed 80% sensitivity and 57.6% specificity. For prediction of uncontrolled diabetes in children with IDA, we concluded that HbA1c increases significantly in diabetic children with IDA. GA may be a useful alternative biomarker for evaluating the glycemic control in such children.
我们评估了糖化白蛋白（GA）和糖化血红蛋白（HbA1c）作为1型糖尿病（T1DM）伴或不伴缺铁性贫血（IDA）儿童血糖控制指标的临床实用性。我们对147名T1DM儿童进行了前瞻性横断面研究，这些儿童被分为I组（患有IDA）和II组（无贫血）。根据过去30天的平均血糖（MBG）将参与者分为血糖控制良好和控制不佳两类。5至12岁儿童MBG高于200，12至15岁儿童MBG高于180mg/dl被视为血糖控制不佳。与无贫血的参与者相比，患有IDA的参与者HbA1c显著升高（p<0.01）。患有IDA的参与者中，HbA1c在血糖控制良好和控制不佳者之间无显著差异（p = 0.5），而GA在血糖控制不佳者中显著高于控制良好者（p = 0.3）。受试者工作特征（ROC）曲线分析显示，GA在截断点为16.9%时，灵敏度为87.2%，特异性为75.8%。HbA1c在截断点为7.09%时，灵敏度为80%，特异性为57.6%。对于预测患有IDA的儿童糖尿病控制不佳，我们得出结论，患有IDA的糖尿病儿童HbA1c显著升高。GA可能是评估此类儿童血糖控制的一种有用的替代生物标志物。
