血糖快速变化对通过微柱和大柱色谱法测定的糖化血红蛋白的影响。

The influence of rapid changes in blood glucose on glycosylated hemoglobin measured by microcolumn and macrocolumn chromatography.

作者信息

Groop L, Maukonen L, Alopaeus K, Ylinen K, Teramo K, Pelkonen R

出版信息

Ann Clin Res. 1982 Aug;14(4):160-4.

Abstract

The effect of a rapid rise in blood glucose on glycosylated hemoglobin (HbA1) was measured by two different cation exchange chromatographic methods. Blood samples were taken after fasting and one hour after breakfast from 32 insulin treated diabetics for the measurement of 1) HbA1 with a microcolumn procedure with and without prior incubation of the samples in saline overnight and 2) HbA1 and HbA1c with the macrocolumn chromatographic method of Trivelli with and without prior dialysis of the hemolysates. Mean (+/- SEM) blood glucose concentration rose significantly one hour after breakfast from 9.8 +/- 0.8 mmol/l to 14.9 +/- 0.8 mmol/l (p less than 0.001). The corresponding HbA1-concentrations measured by microcolumn chromatography without incubation of the samples were 15.2 +/- 0.5% (fasting) of total hemoglobin and 15.8 +/- 0.6% (postprandial) (p less than 0.001) and after incubation 13.3 +/- 0.4% and 13.2 +/- 0.4%, respectively (NS). The HbA1-concentrations measured by the method of Trivelli without dialysis were 14.7 +/- 0.5% (fasting) and 14.9 +/- 0.5% (postprandial) (p less than 0.01) and after dialysis of the hemolysates 14.3 +/- 0.5% and 14.3 +/- 0.5%, respectively (NS). The HbA1c-concentrations measured by the macrocolumn method without dialysis were 11.1 +/- 0.4% (fasting) and 11.2 +/- 0.4% (postprandial) (p less than 0.05) and after dialysis 10.9 +/- 0.4% and 10.8 +/- 0.4%, respectively (NS). Acute hyperglycemia may cause an increase in HbA1-values determined by microcolumn chromatography, the magnitude of which can exceed 20% in an individual case. The acute effect can be abolished by incubation of the samples in saline overnight.

摘要

采用两种不同的阳离子交换色谱法测定血糖快速升高对糖化血红蛋白（HbA1）的影响。对32例接受胰岛素治疗的糖尿病患者在空腹及早餐后1小时采集血样，用于以下检测：1）采用微柱法测定HbA1，血样在盐水中过夜孵育或不孵育；2）采用Trivelli的大柱色谱法测定HbA1和HbA1c，溶血产物透析或不透析。早餐后1小时，平均（±标准误）血糖浓度从9.8±0.8 mmol/L显著升至14.9±0.8 mmol/L（p<0.001）。采用微柱色谱法且血样未孵育时测得的相应HbA1浓度分别为总血红蛋白的15.2±0.5%（空腹）和15.8±0.6%（餐后）（p<0.001），孵育后分别为13.3± 0.4%和13.2±0.4%（无显著性差异）。采用Trivelli法且未透析时测得的HbA1浓度分别为14.7±0.5%（空腹）和14.9±0.5%（餐后）（p<0.01），溶血产物透析后分别为14.3±0.5%和14.3±0.5%（无显著性差异）。采用大柱法且未透析时测得的HbA1c浓度分别为11.1±0.4%（空腹）和11.2±0.4%（餐后）（p<0.05），透析后分别为10.9±0.4%和10.8±0.4%（无显著性差异）。急性高血糖可能导致微柱色谱法测定的HbA1值升高，个别情况下升高幅度可超过20%。将血样在盐水中过夜孵育可消除这种急性效应。