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糖化血红蛋白和糖化血浆蛋白在糖尿病及糖耐量受损诊断中的应用

Glycosylated hemoglobins and glycosylated plasma proteins in the diagnosis of diabetes mellitus and impaired glucose tolerance.

作者信息

Hall P M, Cook J G, Sheldon J, Rutherford S M, Gould B J

出版信息

Diabetes Care. 1984 Mar-Apr;7(2):147-50. doi: 10.2337/diacare.7.2.147.

Abstract

Total and stable glycosylated hemoglobins and glycosylated plasma proteins were determined on 53 patients referred for a glucose tolerance test. Significant correlations were found with fasting blood glucose (r greater than 0.89), 2-h glucose (r greater than 0.69), and area under the glucose tolerance curve (r greater than 0.75), but the correlations with labile glycosylated proteins were not significant. Thirty-one of the patients were normal, five had impaired glucose tolerance (IGT), and seventeen diabetes mellitus (DM) according to the WHO criteria. Comparison of the glycosylated protein values showed that, in all cases, the values for those with IGT and DM were significantly (P less than 0.001) greater than the values for normals. The range of values of stable glycosylated hemoglobins for those with DM (9.4-24.4%), those with IGT (8.6-10.0%), and normals (5.0-8.5%) shows that there was no overlap between overt diabetic subjects and normal subjects. This was also found for total glycosylated hemoglobins. The results for glycosylated plasma proteins, total and stable, were comparable, but one patient with overt DM and two with IGT had values within the normal range. The measurement of glycosylated hemoglobins and glycosylated plasma proteins by the simple, precise, affinity-chromatography method is potentially a quick, accurate, and simple screening test for patients with DM and IGT and deserves consideration as criteria for their diagnosis.

摘要

对53例接受葡萄糖耐量试验的患者测定了总糖化血红蛋白、稳定糖化血红蛋白及糖化血浆蛋白。发现它们与空腹血糖(r>0.89)、2小时血糖(r>0.69)及葡萄糖耐量曲线下面积(r>0.75)有显著相关性,但与不稳定糖化蛋白的相关性不显著。根据世界卫生组织标准,31例患者正常,5例葡萄糖耐量受损(IGT),17例糖尿病(DM)。糖化蛋白值的比较表明,在所有情况下,IGT和DM患者的值均显著高于正常患者(P<0.001)。DM患者(9.4 - 24.4%)、IGT患者(8.6 - 10.0%)及正常患者(5.0 - 8.5%)的稳定糖化血红蛋白值范围表明,显性糖尿病患者与正常受试者之间无重叠。总糖化血红蛋白也有同样的结果。总糖化血浆蛋白和稳定糖化血浆蛋白的结果具有可比性,但1例显性DM患者和2例IGT患者的值在正常范围内。通过简单、精确的亲和色谱法测定糖化血红蛋白和糖化血浆蛋白,对于DM和IGT患者而言,可能是一种快速、准确且简单的筛查试验,值得作为其诊断标准加以考虑。

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