Kawahara R, Amemiya T, Komori T, Hirata Y
Diabetes Care. 1985 Jul-Aug;8(4):375-9. doi: 10.2337/diacare.8.4.375.
We investigated the magnitude of labile A1c in total A1c measured rapidly by a chromatographic method, and whether or not there was an effect of blood glucose before and after a meal on labile A1c in 94 type I and 178 type II diabetic subjects. There were strong correlations between serum glucose and labile A1c both in type I (r = 0.76, P less than 0.001) and in type II diabetic subjects (r = 0.72, P less than 0.001). These relationships did not change before and after the meal. As labile A1c increased in proportion to blood glucose, it could be calculated from the blood glucose level in simultaneous blood samples. In type I diabetic subjects, below the 100-mg/dl glucose level labile a was negligible, and above 100 mg/dl about 0.35% labile A1c was increased every 50-mg/dl increment of glucose. In type II diabetic subjects, below a 150-mg/dl glucose level labile A1c was in the normal range (0.58 +/- 0.15%), and above the 150-mg/dl glucose level every 50-mg/dl increment of glucose increased about 0.3% of labile A1c. If this process is used, stable A1c can be calculated easily from total A1c and coincident serum glucose, even though labile A1c is not removed by incubation.
我们通过色谱法快速测定了94例I型糖尿病患者和178例II型糖尿病患者总糖化血红蛋白（A1c）中不稳定A1c的含量，以及进餐前后血糖对不稳定A1c是否有影响。I型糖尿病患者（r = 0.76，P < 0.001）和II型糖尿病患者（r = 0.72，P < 0.001）的血糖与不稳定A1c之间均存在强相关性。这些关系在进餐前后并未改变。由于不稳定A1c与血糖成比例增加，因此可根据同时采集血样中的血糖水平进行计算。在I型糖尿病患者中，血糖水平低于100 mg/dl时，不稳定A1c可忽略不计，血糖高于100 mg/dl时，血糖每增加50 mg/dl，不稳定A1c约增加0.35%。在II型糖尿病患者中，血糖水平低于150 mg/dl时，不稳定A1c处于正常范围（0.58±0.15%），血糖高于150 mg/dl时，血糖每增加50 mg/dl，不稳定A1c约增加0.3%。如果采用这一方法，即使不稳定A1c未通过孵育去除，也可根据总A1c和同时测定的血糖轻松计算出稳定A1c。
