通过持续葡萄糖监测测定的血红蛋白糖化指数与1型糖尿病并发症之间的相关性
Correlation Between Hemoglobin Glycation Index Measured by Continuous Glucose Monitoring With Complications in Type 1 Diabetes.
作者信息
Ibarra-Salce Raul, Pozos-Varela Francisco Javier, Martinez-Zavala Nestor, Lam-Chung Cesar Ernesto, Mena-Ureta Tania Sofia, Janka-Zires Marcela, Faradji Raquel N, Madrigal-Sanroman Juan Ramon, de la Garza-Hernandez Natalia Eloisa, Almeda-Valdes Paloma
机构信息
Diabetes and Endocrinology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City, Mexico.
Clinica Endi, Miguel Hidalgo, Mexico City, Mexico.
出版信息
Endocr Pract. 2023 Mar;29(3):162-167. doi: 10.1016/j.eprac.2023.01.001. Epub 2023 Jan 7.
OBJECTIVE
HbA1C is the "gold standard" parameter to evaluate glycemic control in diabetes; however, its correlation with mean glucose is not always perfect. The objective of this study was to correlate continuous glucose monitoring (CGM)-derived hemoglobin glycation index (HGI) with microvascular complications.
METHODS
We conducted a cross-sectional study including permanent users of CGM with type 1 diabetes mellitus or latent autoimmune diabetes of the adult. HGI was estimated, and presence of microvascular complications was compared in subgroups with high or low HGI. A logistic regression analysis to assess the contribution of high HGI to chronic kidney disease (CKD) was performed.
RESULTS
In total, 52 participants who were aged 39.7 ± 14.7 years, with 73.1% women and 15.5 years (IQR, 7.5-29 years) since diagnosis, were included; 32.7% recorded diabetic retinopathy, 25% CKD, and 19.2% neuropathy. The median HbA1C was 7.6% (60 mmol/mol) and glucose management indicator (GMI) 7.0% (53 mmol/mol). The average HGI was 0.55% ± 0.66%. The measured HbA1C was higher in the group with high HGI (8.1% [65 mmol/mol] vs 6.9% [52 mmol/mol]; P < .001), whereas GMI (7.0% [53 mmol/mol] vs 7.0% [53 mmol/mol]; P = .495) and mean glucose were similar in both groups (153 mg/dL vs 153 mg/dL; P = .564). In the high HGI group, higher occurrence of CKD (P = .016) and neuropathy were observed (P = .025). High HGI was associated with increased risk of CKD (odds ratio [OR]: 5.05; 95% CI: 1.02-24.8; P = .04) after adjusting for time since diagnosis (OR: 1.09; 95% CI: 1.02-1.16; P = .008).
CONCLUSION
High HGI measured by CGM may be a useful marker for increased risk of microvascular diabetic complications.
目的
糖化血红蛋白（HbA1C）是评估糖尿病血糖控制的“金标准”参数；然而，其与平均血糖的相关性并不总是完美的。本研究的目的是将连续血糖监测（CGM）得出的血红蛋白糖化指数（HGI）与微血管并发症相关联。
方法
我们进行了一项横断面研究，纳入1型糖尿病或成人隐匿性自身免疫性糖尿病的CGM长期使用者。估算HGI，并比较高HGI或低HGI亚组中微血管并发症的存在情况。进行逻辑回归分析以评估高HGI对慢性肾脏病（CKD）的影响。
结果
总共纳入了52名参与者，年龄为39.7±14.7岁，女性占73.1%，自诊断以来病程为15.5年（四分位间距，7.5 - 29年）；32.7%有糖尿病视网膜病变，25%有CKD，19.2%有神经病变。HbA1C中位数为7.6%（60 mmol/mol），血糖管理指标（GMI）为7.0%（53 mmol/mol）。平均HGI为0.55%±0.66%。高HGI组的实测HbA1C更高（8.1% [65 mmol/mol] 对 6.9% [52 mmol/mol]；P <.001），而两组的GMI（7.0% [53 mmol/mol] 对 7.0% [53 mmol/mol]；P =.495）和平均血糖相似（153 mg/dL对153 mg/dL；P =.564）。在高HGI组中，观察到CKD（P =.016）和神经病变的发生率更高（P =.025）。在调整诊断后的时间后，高HGI与CKD风险增加相关（比值比[OR]：5.05；95%置信区间：1.02 - 24.8；P =.04）（OR：1.
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