一种研究基础血糖和餐后血糖对 HbA1 相对贡献的新方法。
A new approach for investigating the relative contribution of basal glucose and postprandial glucose to HbA1.
机构信息
Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.
Department of Endocrinology and Metabolism, The First People's Hospital of Longquanyi District, Chengdu, China.
出版信息
Nutr Diabetes. 2021 Jun 4;11(1):14. doi: 10.1038/s41387-021-00156-1.
To develop an accurate method for evaluating the relative contributions of basal glucose (BG) and postprandial glucose (PPG) to glycated haemoglobin (HbA1c) in subjects with hyperglycaemia using a Continuous Glucose Monitoring System (CGMS®). The subjects were divided into the normal glucose tolerance (NGT), impaired glucose tolerance (IGT), newly-diagnosed type 2 diabetes (NDDM), and drug-treated type 2 diabetes (T2DM) groups. We evaluated the relative contributions of BG and PPG to HbA1c in patients with hyperglycaemia according to three different baseline values. Subjects (n = 490) were grouped as follows: 92 NGT, 36 IGT, 131 NDDM, and 231 T2DM. The relative contributions of PPG to HbA1c were calculated using baseline values of 6.1 mmol/L, 5.6 mmol/L, and the 24-h glucose curve of the NGT group. The relative contribution of PPG to HbA1c decreased progressively from the IGT group to the T2DM group. Compared with the 24-h glucose curve as the baseline, the relative contribution of PPG was overestimated in 9.04% and 1.76% of the subjects when 6.1 mmol/L and 5.6 mmol/L were used as baselines, respectively (P < 0.01), in T2DM patients. The 24-h glucose curve of NGT is more suitable for studying the relative contributions of BG and PPG to HbA1c and it is more precise, as it considers physiological fluctuations in NGT after meals. However, 5.6 mmol/L can be used when the 24-h glucose curve for NGT is unavailable; using 6.1 mmol/L as a baseline value may overestimate the contribution to the HbA1c. There is no unified standard for assessing the contributions of basal glucose (BG) and postprandial glucose (PPG) to HbA1c. The 24-h glucose curve of NGT is more suitable for studying the relative contributions of BG and PPG to HbA1c, as it considers physiological fluctuations in NGT after meals. However, 5.6 mmol/L can be used when the 24-h glucose curve for NGT is unavailable; using 6.1 mmol/L as a baseline value may overestimate the contribution to the HbA1c.
为了使用连续血糖监测系统(CGMS®)开发一种评估高血糖患者中基础血糖(BG)和餐后血糖(PPG)对糖化血红蛋白(HbA1c)相对贡献的准确方法。将受试者分为正常糖耐量(NGT)、糖耐量受损(IGT)、新诊断 2 型糖尿病(NDDM)和药物治疗 2 型糖尿病(T2DM)组。我们根据三种不同的基线值评估了高血糖患者中 BG 和 PPG 对 HbA1c 的相对贡献。受试者(n=490)分为以下几组:92 例 NGT、36 例 IGT、131 例 NDDM 和 231 例 T2DM。使用 6.1mmol/L 和 5.6mmol/L 作为基线值和 NGT 组 24 小时血糖曲线,计算 PPG 对 HbA1c 的相对贡献。PPG 对 HbA1c 的相对贡献从 IGT 组到 T2DM 组逐渐降低。与 24 小时血糖曲线作为基线相比,当分别使用 6.1mmol/L 和 5.6mmol/L 作为基线时,T2DM 患者中有 9.04%和 1.76%的受试者高估了 PPG 的相对贡献(P<0.01)。NGT 的 24 小时血糖曲线更适合研究 BG 和 PPG 对 HbA1c 的相对贡献,因为它考虑了 NGT 餐后的生理波动,因此更精确。然而,当 NGT 的 24 小时血糖曲线不可用时,可以使用 5.6mmol/L;使用 6.1mmol/L 作为基线值可能会高估对 HbA1c 的贡献。评估基础血糖(BG)和餐后血糖(PPG)对 HbA1c 贡献的统一标准尚未确定。NGT 的 24 小时血糖曲线更适合研究 BG 和 PPG 对 HbA1c 的相对贡献,因为它考虑了 NGT 餐后的生理波动,因此更精确。然而,当 NGT 的 24 小时血糖曲线不可用时,可以使用 5.6mmol/L;使用 6.1mmol/L 作为基线值可能会高估对 HbA1c 的贡献。
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