Mortensen H B, Vestermark S, Kastrup K W
Acta Paediatr Scand. 1982 Mar;71(2):217-22. doi: 10.1111/j.1651-2227.1982.tb09402.x.
The glycosylated hemoglobin component, hemoglobin A1c, was estimated in 92 children with insulin dependent diabetes mellitus by an iso-electric focusing procedure during an observation period of 18 months. A significant correlation between hemoglobin A1c and the actual metabolic control according to clinical ratings was found. A seasonal variation in the concentration of the hemoglobin A1c was observed with the lowest level in the months of June and July consistent with an improved metabolic control in the diabetic children during the summer period. A direct relationship was found between metabolic control as assessed by hemoglobin A1c and retarded linear growth expressed as standard deviation score for height. Children with poorly controlled diabetes (initial hemoglobin A1c level above 12.5%) improved their carbohydrate tolerance shown by a significantly lower glycohemoglobin level at the end of the observation period. Consequently, hemoglobin A1c is particularly useful in the routine management of insulin dependent diabetic children in poor metabolic control. Frequent determinations are necessary since in these patients the glucose profiles are prone to great variations, which may lead to changes in the hemoglobin A1c concentration of about 1% in a week.
在18个月的观察期内，采用等电聚焦法对92名胰岛素依赖型糖尿病儿童的糖化血红蛋白组分血红蛋白A1c进行了评估。发现血红蛋白A1c与根据临床评分得出的实际代谢控制情况之间存在显著相关性。观察到血红蛋白A1c浓度存在季节性变化，6月和7月水平最低，这与糖尿病儿童在夏季代谢控制改善相一致。通过血红蛋白A1c评估的代谢控制与以身高标准差评分表示的生长发育迟缓之间存在直接关系。糖尿病控制不佳的儿童（初始血红蛋白A1c水平高于12.5%）在观察期结束时糖化血红蛋白水平显著降低，显示其碳水化合物耐受性有所改善。因此，血红蛋白A1c在代谢控制不佳的胰岛素依赖型糖尿病儿童的常规管理中特别有用。由于这些患者的血糖曲线容易出现很大波动，可能导致血红蛋白A1c浓度在一周内变化约1%，因此需要频繁测定。
