Abbott Diabetes Care, Alameda, California.
Centre Hospitalier de Mouscron, Service de diabétologie et endocrinologie, Mouscron, Belgium.
Diabetes Obes Metab. 2022 Dec;24(12):2383-2390. doi: 10.1111/dom.14824. Epub 2022 Aug 11.
To evaluate the accuracy of a novel kinetic model at predicting HbA1c in a real-world setting and to understand and explore the role of diabetes complications in altering the glucose-HbA1c relationship and the mechanisms involved.
Deidentified HbA1c and continuous glucose monitoring values were collected from 93 individuals with type 1 diabetes. Person-specific kinetic variables were used, including red blood cell (RBC) glucose uptake and lifespan, to characterize the relationship between glucose levels and HbA1c. The resulting calculated HbA1c (cHbA1c) was compared with glucose management indicator (GMI) for prospective agreement with laboratory HbA1c.
The cohort (42 men and 51 women) had a median age (IQR) of 61 (43, 72) years and a diabetes duration of 21 (10, 33) years. A total of 24 459 days of continuous glucose monitoring (CGM) data were available and 357 laboratory HbA1c were used to assess the average glucose-HbA1c relationship. cHbA1c had a superior correlation with laboratory HbA1c compared with GMI with a mean absolute deviation of 1.7 and 6.7 mmol/mol, r = 0.85 and 0.44, respectively. The fraction within 10% of absolute relative deviation from laboratory HbA1c was 93% for cHbA1c and 63% for GMI. Macrovascular disease had no effect on the model's accuracy, whereas microvascular complications resulted in a trend towards higher HbA1c, secondary to increased RBC glucose uptake.
cHbA1c, which takes into account RBC glucose uptake and lifespan, accurately reflects laboratory HbA1c in a real-world setting and can aid in the management of individuals with diabetes.
评估一种新型动力学模型在真实环境中预测糖化血红蛋白（HbA1c）的准确性，并了解和探索糖尿病并发症在改变血糖-HbA1c 关系中的作用以及涉及的机制。
从 93 名 1 型糖尿病患者中收集了匿名的 HbA1c 和连续血糖监测值。使用个体特定的动力学变量，包括红细胞（RBC）葡萄糖摄取和寿命，来描述血糖水平与 HbA1c 之间的关系。所得计算的 HbA1c（cHbA1c）与葡萄糖管理指标（GMI）进行前瞻性一致性比较，以评估与实验室 HbA1c 的一致性。
该队列（42 名男性和 51 名女性）的中位（IQR）年龄为 61（43，72）岁，糖尿病病程为 21（10，33）年。共获得 24459 天的连续血糖监测（CGM）数据，并用 357 个实验室 HbA1c 评估平均血糖-HbA1c 关系。与 GMI 相比，cHbA1c 与实验室 HbA1c 的相关性更好，平均绝对偏差分别为 1.7 和 6.7mmol/mol，r 值分别为 0.85 和 0.44。cHbA1c 与实验室 HbA1c 的绝对相对偏差在 10%以内的比例为 93%，而 GMI 的比例为 63%。大血管疾病对模型的准确性没有影响，而微血管并发症导致 HbA1c 升高，这是由于 RBC 葡萄糖摄取增加所致。
cHbA1c 考虑了 RBC 葡萄糖摄取和寿命，在真实环境中准确反映实验室 HbA1c，可以帮助管理糖尿病患者。
