糖化白蛋白、糖化白蛋白/糖化血红蛋白与2型糖尿病合并冠心病相关性的研究

目的 探讨T2DM合并冠心病(CAD)与糖化白蛋白(GA)、HbA₁c、GA/HbA₁c的相关性。方法 选取2018年1月至2021年12月于承德医学院附属医院内分泌科住院的T2DM患者596例,根据是否合并CAD分为单纯T2DM组(n=304)和T2DM合并CAD组(CAD,n=292)。比较两组一般资料、生化指标、GA、HbA₁c、GA/HbA₁c。Pearson相关分析GA/HbA₁c、GA与其他指标的相关性。Logistic回归分析T2DM合并CAD的影响因素。结果 CAD组男性比例、年龄、DM病程、吸烟史比例、CAD家族史比例、SBP、FPG、2 hPG、GA、GA/HbA₁c高于T2DM组(P<0.05或P<0.01)。Pearson相关分析显示,GA与2 hPG、HbA₁c、GA/HbA₁c呈正相关(P<0.05),与BMI呈负相关(P<0.05)。GA/HbA_1<...     

糖化白蛋白与糖尿病

糖化白蛋白是葡萄糖与血浆白蛋白发生非酶糖化反应的产物,其值能反映糖尿病患者近2～3周内的平均血糖水平,是反映短期血糖控制的较好指标.同时糖化白蛋白具有促动脉粥样硬化的作用,亦是评估糖尿病合并冠心病时冠状动脉病变严重程度的一项敏感指标.现对糖化白蛋白对糖尿病的诊疗价值进行综述.     

血清总胆红素、糖化白蛋白、糖化血红蛋白与糖尿病血管并发症的关系

目的探讨血清总胆红素(TBIL)、糖化白蛋白(GA)、糖化血红蛋白(Hb A1c)与糖尿病血管并发症的关系。方法选取糖尿病患者176例,根据是否有血管并发症分为血管病变组和无血管病变组。测定两组TBIL、GA、Hb A1c等生物化学指标。采用Logistic二元回归分析糖尿病患者血管并发症的影响因素。结果最终纳入血管病变组的有120例,纳入无血管病变组的有56例。两组性别、年龄、体质指数(BMI)比较差异无统计学意义(P0. 05)。与无血管病变组比较,血管病变组患者的病程更长,总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、TBIL数值更低,GA、Hb A1c、甘油三酯(TG)和低密度脂蛋白胆固醇(LDLC)数值更高,差异具有统计学意义(P0. 05);进一步二元Logistic回归分析结果显示,Hb A1c水平高、TBIL水平低和病程长是糖尿病血管并发症的独立危险因素(P0. 05)。结论临床应积极关注糖尿病患者的Hb A1c和TBIL水平,注意血管病变的筛查并积极干预,避免严重并发症的发生。     

糖耐量、糖化血红蛋白、糖化白蛋白联合C肽检测应用于糖尿病诊断中价值分析

目的探讨糖耐量、糖化血红蛋白、糖化白蛋白联合C肽应用于糖尿病诊断中的价值,为临床诊疗提供参考价值。方法选取该院2018年1月—2019年1月所收治2型糖尿病患者315例为研究组,另选同期健康体检者255例为对照组。分别进行糖耐量、糖化血红蛋白、糖化白蛋白、C肽检测,比较组间差异。结果在4个时间点,研究组糖耐量均高于对照组,差异有统计学意义(P<0.05);在T0、T2、T3,研究组C肽水平均高于对照组,差异有统计学意义(P<0.05);在T1时,研究组C肽水平为(2.2±0.5)mmol/L,低于对照组的(8.4±1.6)mmol/L,差异有统计学意义(P<0.05)。研究组患者中,糖化白蛋白为(18.6±4.9)mmol/L、糖化血红蛋白为(8.1±1.9)mmol/L,均高于对照组(P<0.05)。结论糖耐量、糖化血红蛋白、糖化白蛋白及C肽联合检测可全面反应血糖控制及胰岛素分泌情况,有利于鉴别有无糖尿病、胰岛素水平及长短期治疗效果,对临床诊疗具有积极意义,值得临床推广应用。     

糖尿病肾病患者尿微量白蛋白与糖化血红蛋白等代谢指标的相关性

糖尿病肾脏病变(DN)的发生、发展与长期高血糖导致的多种代谢异常密切相关。本研究测定了DN的主要指标尿白蛋白排泄率(UAER)、糖化血红蛋白(HbA1c)、红细胞醛糖还原酶(AR)、超氧化物岐化酶(SOD)、血清一氧化氮(NO)水平，研究其相关性并探讨DN的可能发病机制。     

糖化白蛋白的影响因素及应用

糖化白蛋白是糖尿病患者血糖监测的重要指标,与糖尿病血管病变、周围神经病变等并发症密切相关.近年来研究表明,糖化白蛋白易受年龄、体重指数、白蛋白更新速度、疾病及激素的影响.糖化白蛋白可用于及时评价糖尿病患者治疗效果,能更好的反映餐后高血糖及血糖波动情况,并能评估氧化应激及糖尿病慢性并发症,辅助鉴别诊断糖尿病及应激性高血糖等.了解糖化白蛋白的影响因素及应用可更好的指导糖尿病及其相关并发症的诊断和治疗.     

体重指数对糖化血红蛋白及糖化白蛋白影响的研究

目的分析BMI对HbA₁c及糖化白蛋白(GA)的影响。方法选取北京市平谷区代谢性疾病研究中3895名26~76岁常住居民数据。按FPG、2 hPG分层比较BMI各四分位数分组的HbA₁c、GA水平;采用多因素线性回归模型分析HbA₁c、GA的影响因素。结果调整年龄、性别、血红蛋白后,在4.0≤FPG<6.0 mmol/L(P<0.001)、6.0≤FPG<7.0 mmol/L(P=0.003)、7.0≤FPG<8.0 mmol/L(P=0.030)及所有2 hPG(P<0.001)分层中,HbA₁c随BMI四分位数升高呈递增趋势;在4.0≤FPG<6.0 mmol/L(P<0.001)、6.0≤FPG<7.0 mmol/L(P=0.032)、FPG≥8.0 mmol/L(P<0.001)、2.0≤2 hPG<6.0 mmol/L(P<0.001)、6.0≤2 hPG<8.0 mmol/L(P<0.001)和8.0≤2 hPG<10.0 mmol/L(P<0.001)时,GA随BMI四分位数升高呈递减趋势。多因素线性回归分析显示,BMI是HbA₁c、GA的影响因素(β=0.018、-0.094,R²=0.723、0.696,P<0.01)。结论在普通人群中,调整血糖因素后,当FPG<8.0 mmol/L时,HbA₁c随BMI升高而增加,当2 hPG<10.0mmol/L时,GA随BMI升高而减少。     

糖化血清白蛋白检测与糖尿病及其并发症

血糖监测可反映糖尿病患者糖代谢紊乱状态,是糖尿病降血糖治疗过程中不可缺少的重要环节.糖化血清白蛋白(GA)是葡萄糖与血清白蛋白发生非酶糖化反应的产物,反映糖尿病治疗近2～3周内平均血糖水平,在临床上用于评价糖尿病短期血糖控制水平及药物疗效等,具有较高的实用价值.与糖尿病血糖监测的其他指标比较,GA有诸多优势.同时,GA与糖尿病慢性并发症密切相关,对于糖尿病合并多种疾病的患者,GA较糖化血红蛋白(Hb)A1c及糖化血清蛋白(CSP)能够更敏感、更快速、更准确地反映血糖控制水平.     

糖化血红蛋白、糖化白蛋白及空腹血糖在糖尿病诊断中的价值

目的：评估糖化血红蛋白（HbA1c）、血清糖化白蛋白（Glycated Albumin,GA）及空腹血糖（Fasting Plasma Glucose, FPG）在糖尿病（ Diabetes Mellitus,DM）患者早期诊断中的价值。方法收集2010～2013年浙江省台州医院同时检测HbA1c、GA及FPG的人群的相关数据,分为糖尿病组和非糖尿病组,进行受试者工作特征曲线（ Receiver Operator Character-istic curve,ROC曲线）分析以得出3种指标诊断DM的cut-off值、曲线下面积（ Area Under the Curve,AUC）其灵敏度、特异性,再进一步计算3种指标联合诊断DM的灵敏度及特异性。结果①DM组的HbA1c、GA及FPG均高于非DM 组（ HbA1c：9．14％vs．5．84％, P ＝0．000;GA：24．8mmol/Lvs．13．8mmol/L, P ＝0．000;FPG：9．65mmol/L vs．5．77mmol/L, P ＝0．000）。②HbA1c诊断DM的cut-off值为6．85％,AUC为0．911,灵敏度为84．2％,特异性为96．2％;GA诊断DM的cut-off值为17．5,AUC为0．881,灵敏度为71．6％,特异性为93．6％;FPG诊断DM的cut-off值为7．52mmol/L,AUC为0．836,灵敏度为70．2％,特异性为82．1％。③HbA1c、GA及FPG联合诊断DM的灵敏度及特异性分别为91．1％,76．3％。结论HbA1c、GA及FPG对DM皆有诊断价值,其中HbA1c的诊断DM效能最大。 HbA1c、GA及FPG联合诊断可提高DM诊断的灵敏度,在DM筛查中具有重要价值。     

糖化白蛋白在妊娠期糖尿病合并地中海贫血的临床应用研究

目的 探讨糖化白蛋白对妊娠期糖尿病(GDM)合并地中海贫血患者的临床应用价值.方法 选取2020年6月—2021年6月在惠州市第三人民医院进行产前筛查的46例地中海贫血合并妊娠期糖尿病(GDM)孕妇为合并组,49例单纯GDM孕妇为单纯组,50名健康孕妇为健康对照组.比较3组孕妇糖化血红蛋白(HbA1c)、空腹血糖(FP...     

Serum glycated albumin,but not glycated hemoglobin,is low in relation to glycemia in men with hypertriglyceridemia

Aims/Introduction: Serum glycated albumin (GA) and glycated hemoglobin (HbA_1c) are influenced by plasma glucose levels, and are used for monitoring chronic glycemic control in diabetic patients. Both glycated proteins are known to be influenced by various factors other than plasma glucose levels. In the present study, we examined the effects of hypertriglyceridemia on them. Materials and Methods: The present study comprised 273 non‐diabetic men. They were grouped into men with normotriglyceridemia (serum triglyceride [TG] <150 mg/dL) and those with hypertriglyceridemia (serum TG ≥150 mg/dL). Results: Body mass index (BMI) and high sensitivity C‐reactive protein (hs‐CRP) were significantly higher in the 160 men with hypertriglyceridemia than the 113 men with normotriglyceridemia. In men with hypertriglyceridemia, as compared with those with normotriglyceridemia, fasting plasma glucose, 2‐h plasma glucose after 75 g oral glucose tolerance test, and HbA_1c were significantly higher. By contrast, serum GA was significantly lower in men with hypertriglyceridemia. BMI‐adjusted serum GA was also significantly lower in these men. In a multivariate analysis, serum TG was an inverse explanatory variable for serum GA. Conclusions: Serum GA is low in relation to plasma glucose levels in men with hypertriglyceridemia. This might be caused by increased albumin metabolism associated with hypertriglyceridemic state. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2010.00049.x, 2010)     

Prediction of near‐future glycated hemoglobin levels using glycated albumin levels before and after treatment for diabetes

Aims/Introduction: In the present study, whether near‐future glycated hemoglobin (A1C) levels could be predicted by changes in glycated albumin (GA) levels before and after treatment for diabetes was investigated. Materials and Methods: After starting diabetes treatment, GA and A1C levels are assumed to change exponentially. From this assumption, the equation for predicting near‐future GA and A1C levels was derived. A total of 54 patients with type 2 diabetes mellitus in whom diabetes treatment was initiated or altered were enrolled. By incorporating GA and A1C values before and 2–4 weeks after starting treatment (second visit) into the equation, the predicted GA and A1C levels at the third visit (5–7 weeks after treatment) were obtained. Results: A strong and positive correlation was observed between predicted GA and measured GA at the third visit (R = 0.669, P < 0.0001). Similarly, a strong and positive correlation was observed between the predicted A1C and the measured A1C at the third visit (R = 0.795, P < 0.0001). Conclusions: GA and A1C levels 1–3 months after starting diabetes treatment could be predicted using the equation developed. The prediction of near‐future A1C levels using GA levels at two points would be useful for judging the effectiveness of ongoing diabetes treatment at an earlier stage. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00107.x, 2011)     

Introduction of glycated albumin measurement for all blood donors and the prevalence of a high glycated albumin level in Japan

(J Diabetes Invest, doi: 10.1111/j.2040‐1124.2012.00224.x, 2012) Aims/Introduction: The Japanese Red Cross Society introduced measurement of glycated albumin (GA) for all blood donors as a glycemic control marker. The GA levels were examined by sex and age. Materials and Methods: GA was measured in 3.14 million blood donors who donated between April 2009 and March 2010. For the reference range for GA, values that were three times the reference range for glycated hemoglobin (Japan Diabetes Society value) were used. All donors were notified of their GA levels. For repeat donors, a comparison was made between the GA levels at the first and second donations to verify the GA change after notification. Results: The mean GA was significantly lower in males than in females in donors aged <60 years. The mean GAs of both sexes increased with age and reached the same level of 14.8% in their 60s. The percentage of donors with prediabetes/diabetes (GA ≥16.5%) was 2.8% in males and 2.3% in females. In the normal high group (15.6% ≤ GA < 16.5%), the mean GA at the second donation was lower by 0.20% than at the first donation. In 42.4% of these donors, GA decreased to the normal range at the second donation. Conclusions: Overall, 2.7% of otherwise healthy Japanese blood donors had a high GA (GA ≥16.5%). Donor blood screening for GA represents an effective measure to identify people at risk of diabetes. The decrease in the GA level after GA notification might indicate the potential usefulness of this strategy to improve glycemic control among people with high GA.     

Serum enzymes of lysosomal origin as indicators of the metabolic control in diabetes: Comparison with glycated hemoglobin and albumin

Summary Several lysosomal enzymes (β-N-D-acetylglucosaminidase, β-D-glucoronidase, α-D-galactosidase, β-D-galactosidase, α-L-fucosidase, α-D-glucosidase, α-D-mannosidase, β-D-glucosidase), glycated albumin and glycated hemoglobin (HbA_1c) were determined in the serum of 81 insulin-dependent diabetics with different degrees of metabolic control (optimal, 21 patients; good, 39 patients; poor, 21 patients) and without signs of complications, and in 42 control subjects. All parameters examined increased in serum in inverse proportion to the degree of metabolic control. A highly significant correlation (p<0.01) was found between lysosomal enzymes and both glycated albumin and HbA_1c. All parameters correlated with hyperglycemia, glycated albumin having the highest γ-value (0.586) and lysosomal enzymes the lowest one. Unlike glycated albumin and HbA_1c, serum levels of lysosomal enzymes in patients with optimal metabolic control were undistinguishable or even lower than those of controls. A 2-month longitudinal monitoring of a patient who was hospitalized in conditions of poor metabolic control and adequately treated, proved that lysosomal enzymes diminished in serum parallel to glycated albumin and HbA_1c in relation to improvement of the metabolic situation. The conclusion is drawn that serum lysosomal enzymes are good indicators of the metabolic control of diabetic patients probably reflecting the overall metabolic state connected with insulin action rather than hyperglycemia.     

糖化血清白蛋白在2型糖尿病监测及诊断中的应用观察

目的 研究糖化血清白蛋白(GA)与糖化血红蛋白(HbA1c)、空腹血糖(FPG)及餐后2小时血糖(2hPG)的关系,探讨GA在糖尿病的诊断及血糖监测方面的价值.方法 对796例受试者行口服葡萄糖耐量试验(OGTT),测定FPG、GA、HbA1c和2hPG,分析各指标间的相关性及GA诊断糖尿病的最佳切点.结果 (1)GA与FPG、2hPG呈显著正相关(r值分别为0.625、0.644,P＜0.01).(2)GA诊断糖尿病的最佳切点为18.55％,敏感度为75.1％,特异度为80.7％.结论 GA、HbA1c与FPG、2hPG关系密切,GA是诊断糖尿病的一种高信度指标.     

Elevation of the glycated albumin to glycated hemoglobin ratio during the progression of hepatitis C virus related liver fibrosis

AIM: To analyze the relationship between the glycated albumin (GA) to glycated hemoglobin (HbA1c) ratio and the histological grading of liver fibrosis.METHODS: The study retrospectively included consecutive hepatitis C virus positive chronic liver disease patients (n = 142) who had undergone percutaneous liver biopsy between January 2008 and March 2010 at our institution. The ratios of GA/HbA1c were calculated in all patients to investigate the relationship with the degree of the liver fibrosis. The values of the aspartate aminotransferase-to-platelet ratio index (APRI), an excellent marker for the evaluation of liver fibrosis, were also calculated. In addition, we combined the ratio of GA/HbA1c and the APRI in order to improve our ability to detect the presence of significant liver fibrosis. RESULTS: Sixty-one (43%) patients had either no fibrosis or minimal fibrosis (METAVIR score: F0-F1), while 25 (17%) had intermediate fibrosis (F2). Fifty-six (39%) patients had severe fibrosis (F3-F4) and 27 of them had cirrhosis (F4). The mean values of the GA/HbA1c increased with the progression of the fibrosis (F0-1: 2.83 ± 0.24, F2: 2.85 ± 0.24, F3: 2.92 ± 0.35, F4: 3.14 ± 0.54). There was a significant dif- ference between the F0-F1 vs F4, F2 vs F4, and F3 vs F4 groups (P < 0.01, P < 0.01, P < 0.01 and P < 0.05, respectively). The GA/HbA1c ratio was significantly higher in the patients with cirrhosis (F4) than in those without cirrhosis (F0-F3) (3.14 ± 0.54 vs 2.85 ± 0.28, P < 0.0001). The GA/HbA1c ratio was also significantly higher in the patients with severe fibrosis (F3-F4) than in those without severe liver fibrosis (F0-F2) (3.03 ± 0.41 vs 2.84 ± 0.24, P < 0.001). Furthermore, the GA/ HbA1c ratio was also significantly higher in the patients with significant fibrosis (F2-F4) than in those without significant liver fibrosis (F0-F1) (2.98 ± 0.41 vs 2.83 ± 0.24, P < 0.001). The diagnostic performance of the increased GA/HbA1c ratio (> 3.0) was as follows: its sensitivity and specificity for the detection of liver cirrhosis (F4) were 59.3% and 70.4%, respectively and its sensitivity and specificity for the detection of severe liver fibrosis (F3-F4) were 50.0% and 74.4%,respectively. With regard to the detection of significant fibrosis (F2-F4), its sensitivity was 44.4% and its specificity was 77.0%. Although even the excellent marker APRI shows low sensitivity (25.9%) for distinguishing patients with or without significant fibrosis, the combination of the APRI and GA/HbA1c ratio increased the sensitivity up to 42.0%, with only a modest decrease in the specificity (from 90.2% to 83.6%). CONCLUSION: The GA/HbA1c ratio increased in line with the histological severity of liver fibrosis, thus suggesting that this ratio is useful as a supportive index of liver fibrosis.     

Does ethanol intake interfere with the evaluation of glycated hemoglobins?

Summary Ethanol and/or its metabolites interfere with the chromatographic assay of glycated hemoglobins. Fasting plasma glucose, blood ethanol, HbA₁, HbA_a1+b, MCV and GGT were determined in 22 control subjects, 22 alcoholics, 22 diabetic patients and 22 alcoholic diabetic patients. Fasting plasma glucose and all hemoglobin fractions were lower in alcoholic subjects and, except for HbA_1a+b, higher in diabetic patients and in alcoholic diabetic patients. HbA₁ and HbA_1c correlated well with plasma glucose but not with blood ethanol, MCV and GGT. Glycated hemoglobin was not found to be a useful marker for alcohol abuse. With the chromatographic method we used, the evaluation of glycated hemoglobin fractions, chiefly HbA_1c, confirms its usefulness in monitoring the metabolic control of diabetic subjects, even in case of ethanol abuse.