Daneman D, Tsalikian E, Hengstenberg F, Becker D J, Drash A L
Diabetologia. 1980 Nov;19(5):423-6. doi: 10.1007/BF00281820.
Glycosylated haemoglobin (HbA1) was measured serially by microcolumn chromatography in 38 children with newly diagnosed insulin-dependent diabetes. Initial HbA1 levels of 13.6 +/- 0.5% fell signficiantly from day 0 (prior to therapy) both to day 1 (1.6 +/- 0.2% decrease) and to day 3-5 (2.6 +/- 0.4% decrease) (P < 0.001). This drop correlated closely with changes in blood glucose (P < 0.001), less closely and inversely with plasma bicarbonate levels (P < 0.01), but not with prior duration of symptoms or changes in serum cholesterol and triglyceride concentrations. HbA1 levels reached a nadir of 8.2 +/- 0.3% 3 weeks to 6 months after diagnosis, and correlated with decreasing insulin dosage (P < 0.001). HbA1 levels rose again to 11.4 +/- 0.5% in 21 patients followed for more than 3-6 months. Our results indicate that (1) HbA1 level change rapidly during initial stabilization of insulin-dependent diabetes suggesting that glycosylation may not be entirely irreversible, and (2) HbA1 levels are consistent with clinical assessment of control during remission and postremission phases.
采用微柱色谱法对38例新诊断的胰岛素依赖型糖尿病患儿的糖化血红蛋白（HbA1）进行了连续测定。初始HbA1水平为13.6±0.5%，从第0天（治疗前）到第1天（下降1.6±0.2%）以及到第3 - 5天（下降2.6±0.4%）均显著下降（P < 0.001）。这种下降与血糖变化密切相关（P < 0.001），与血浆碳酸氢盐水平的相关性较弱且呈负相关（P < 0.01），但与症状的先前持续时间以及血清胆固醇和甘油三酯浓度的变化无关。HbA1水平在诊断后3周至6个月达到最低点8.2±0.3%，并与胰岛素剂量的减少相关（P < 0.001）。在随访超过3 - 6个月的21例患者中，HbA1水平再次升至11.4±0.5%。我们的结果表明：（1）在胰岛素依赖型糖尿病初始稳定期，HbA1水平变化迅速，提示糖基化可能并非完全不可逆；（2）HbA1水平与缓解期和缓解后期的临床控制评估一致。
