糖化血红蛋白可预测葡萄糖耐量受损的皮马印第安人患糖尿病的进展情况。
Glycated haemoglobin predicts progression to diabetes mellitus in Pima Indians with impaired glucose tolerance.
作者信息
Little R R, England J D, Wiedmeyer H M, Madsen R W, Pettitt D J, Knowler W C, Goldstein D E
机构信息
Department of Pathology, University of Missouri, School of Medicine, Columbia 65212.
出版信息
Diabetologia. 1994 Mar;37(3):252-6. doi: 10.1007/BF00398051.
Glycated haemoglobin could offer several practical advantages over the OGTT for assessing glucose metabolism. Initial cross-sectional studies (1983-1985) on 381 subjects (mostly Pima Indians) described the relationship between HbA1c (a specific glycated Hb) and the OGTT. We performed follow-up OGTTs and HbA1c measurements on 257 of these same subjects 1.6-6.1 years later. Subjects were again grouped according to both the result of the OGTT (normal, IGT or diabetes, by WHO criteria) and HbA1c result (normal or elevated based on mean +/- 1.96 SD of normal). Of 66 subjects with IGT at baseline, 47 (71%) had normal HbA1c and 19 (29%) had elevated HbA1c. Twenty-six (39%) of these subjects had diabetes at follow-up. Of these subjects with IGT, a significantly greater percentage of subjects with elevated HbA1c at baseline (68%) showed worsening to diabetes than those with a normal HbA1c (28%); (chi-square = 7.8, df = 1, p < 0.01). Thus, in subjects with IGT, glycated Hb may be a useful predictor of progression to diabetes.
在评估葡萄糖代谢方面，糖化血红蛋白相较于口服葡萄糖耐量试验（OGTT）可能具有几个实际优势。最初在1983年至1985年对381名受试者（大多数为皮马印第安人）进行的横断面研究描述了糖化血红蛋白A1c（一种特定的糖化血红蛋白）与OGTT之间的关系。1.6至6.1年后，我们对其中257名相同的受试者进行了后续的OGTT和糖化血红蛋白A1c测量。根据OGTT结果（按照世界卫生组织标准分为正常、糖耐量受损或糖尿病）和糖化血红蛋白A1c结果（基于正常均值±1.96标准差分为正常或升高）再次对受试者进行分组。在基线时66名糖耐量受损的受试者中，47名（71%）糖化血红蛋白A1c正常，19名（29%）糖化血红蛋白A1c升高。这些受试者中有26名（39%）在随访时患有糖尿病。在这些糖耐量受损的受试者中，基线时糖化血红蛋白A1c升高的受试者中出现糖尿病病情恶化的比例（68%）显著高于糖化血红蛋白A1c正常的受试者（28%）；（卡方检验=7.8，自由度=1，p<0.01）。因此，在糖耐量受损的受试者中，糖化血红蛋白可能是预测糖尿病进展的有用指标。
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