Kilpatrick E S, Dominiczak M H, Small M
Department of Pathological Biochemistry, Gartnavel General Hospital, Glasgow, UK.
QJM. 1996 Apr;89(4):307-12. doi: 10.1093/qjmed/89.4.307.
To investigate the discrepancy in the assessment of glycaemic control using glycated haemoglobin (HbA1C) and glycated proteins (fructosamine), the effect of age on these variables was measured in non-diabetic individuals. In 232 non-diabetics, there was a linear relationship between HbA1C and age (r = 0.49, p < 0.0001). Mean HbA1C rose from 3.82% to 4.44% between the ages of 20 and 70. Consequently, when Type 2 diabetic patient samples (n = 128, median age 63 years) were classified according to European guidelines into good or poor glycaemic control using both an age-matched (n = 101) and a younger (n = 108, median age 37 years) non-diabetic reference population, fewer patients were in good control (14% vs. 25%) and more in poor control (73% vs. 53%) when the younger reference population was used (both p < 0.05). In a subgroup of 126 non-diabetic subjects, HbA1C rose with age (r = 0.48), but serum fructosamine and fasting glucose did not (r = 0.07, r = 0.009, respectively, p = NS). Age-associated differences in non-diabetic HbA1C values may affect the assessment of glycaemic control in diabetic patients. It may also partly explain discrepancies found when comparing fructosamine with HbA1C as a measure of glucose control. Age-related HbA1C reference intervals may therefore be required for the treatment of patients and the accurate auditing of clinic performance.
为了研究使用糖化血红蛋白（HbA1C）和糖化蛋白（果糖胺）评估血糖控制情况时的差异，我们在非糖尿病个体中测量了年龄对这些变量的影响。在232名非糖尿病患者中，HbA1C与年龄之间存在线性关系（r = 0.49，p < 0.0001）。20岁至70岁之间，平均HbA1C从3.82%升至4.44%。因此，当根据欧洲指南，将2型糖尿病患者样本（n = 128，中位年龄63岁）与年龄匹配的非糖尿病参考人群（n = 101）和较年轻的非糖尿病参考人群（n = 108，中位年龄37岁）进行比较，以分类血糖控制的好坏时，使用较年轻参考人群时，处于良好控制的患者较少（14%对25%），处于不良控制的患者较多（73%对53%）（p均< 0.05）。在126名非糖尿病受试者的亚组中，HbA1C随年龄升高（r = 0.48），但血清果糖胺和空腹血糖则不然（分别为r = 0.07，r = 0.009，p =无统计学意义）。非糖尿病患者HbA1C值的年龄相关差异可能会影响糖尿病患者血糖控制的评估。这也可能部分解释了在比较果糖胺与HbA1C作为血糖控制指标时发现的差异。因此，治疗患者和准确审核临床绩效可能需要与年龄相关的HbA1C参考区间。
