Little R R, England J D, Wiedmeyer H M, Madsen R W, Pettitt D J, Knowler W C, Goldstein D E
Department of Pathology, University of Missouri, School of Medicine, Columbia 65212.
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。
