糖尿病患者1,5-脱水葡萄糖醇、糖化血清蛋白、血糖、糖化血红蛋白与胰岛素水平相关性及其诊断价值

目的探讨糖尿病患者1,5-脱水葡萄糖醇(AG)、糖化血清蛋白(GSP)、血糖(Glu)、糖化血红蛋白(HbA1c)与胰岛素水平相关性及其诊断价值。方法利用生化检测法、发光免疫检测法,检测30例确诊(按照WHO标准)为糖尿病的患者的1,5-AG、GSP、Glu、HbA1c及胰岛素水平,将其设为观察组;并且以同样的方法检测30例正常健康者的1,5-AG、GSP、Glu、HbA1c及胰岛素水平,将其设为对照组,观察比较这两组患者中检验项目的差别,总结彼此之间的相关性以及对糖尿病临床诊断所起到的作用。结果观察组患者的GSP、1,5-AG、HbA1c以及胰岛素水平明显高于对照组(P<0.05);观察组患者的Glu检测水平明显低于对照组;糖尿病患者Glu与GSP、1,5-AG、HbA1c及胰岛素之间均呈负相关。结论糖尿病患者1,5-AG、GSP、Glu、HbA1c及胰岛素之间具有较好的相关性,对糖尿病临床诊断具有重要的指导意义,能够真实、客观地反映出病变情况。     

对糖化血红蛋白与血脂检测在2型糖尿病检测中的临床意义进行探究

选2019年1月～ 2020年1月期间80例T2DM患者为实验组,80例糖耐量正常人为对照组,结果实验组HbA1c、空腹血糖(FPG)、血脂总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白和低密度脂蛋白等指标与对照组对比差异明显(P＜0.05).结论T2DM的HbA1c和血脂等指标具有密切的内在关系.     

空腹血糖和糖化血红蛋白用于筛查糖尿病的研究

目的评估空腹血糖(FPG)和糖化血红蛋白(HbA1c)在筛查糖尿病(DM)和糖耐量受损(IGT)中的应用价值。方法北京地区研究对象1118名,为明确DM诊断而就诊者和DM高危人群接受DM筛查者,男489名,女629名,平均48±12岁,行口服葡萄糖耐量试验(OGTT)并测定HbA1c。结果按照1999年WHO的DM诊断标准,本研究人群糖耐量正常(NGT)、空腹血糖受损(IFG)、IGT、IGT合并IFG和DM者分别为510、35、155、52、366例。采用受试者工作特征曲线(ROC曲线)判断,与以OGTT诊断的DM状态相关的FPG临界点为6.2mmol/L,敏感性和特异性分别为85.0%和90.4%,曲线下面积0.943(95%CI0.927～0.959),阳性似然比8.9,阴性似然比0.2;与以OGTT诊断的DM状态相关的HbA1c临界点为6.2%,敏感性和特异性分别为86.6%和77.5%,曲线下面积0.896(95%CI0.876～0.916),阳性似然比3.9,阴性似然比0.2。与IGT状态相关的FPG临界点为5.1mmol/L,敏感性和特异性分别为65.2%和68.3%,曲线下面积为0.729,阳性似然比2.1,阴性似然比0.5。与IGT状态相关的HbA1c临界点为5.7%,敏感性和特异性分别63.3%和56.5%,曲线下面积为0.634,阳性似然比1.5,阴性似然比0.7。结论6.2mmol/L6.2%时应进一步行OGTT了解2h血糖以明确有无DM,FPG和HbA1c不适用于筛查IGT人群。     

空腹血糖、果糖胺和糖化血红蛋白联合检测在2型糖尿病患者中的应用

目的探讨空腹血糖（FBG）、果糖胺（GSP）、糖化血红蛋白（HbAlc）三者联合检测在糖尿病患者的诊断中的应用价值。方法收集自2013年6月—2014年1月之间,该院糖尿病专科200例糖尿病患者作为实验组,另选择健康体检者100例作为对照组。分别检测两组的FBG、GSP、HbAlc浓度并进行比较。结果糖尿病组的FBG、GSP、HbAlc浓度均高于对照组,两组差异明显有统计学意义（P〈0.05）。FBG、GSP、HbAlc三者联合检测糖尿病的阳性率明显高于其任意一项单独检测。结论FBG、GSP、HbAlc三者密切相关,分别为糖尿病患者提供即时、近期和长期的血糖信息,三者联合检测在糖尿病患者的早期筛查有着重要的意义。尤其是脆性糖尿病,意义更大。     

老年高血压患者糖化血红蛋白水平与颈动脉粥样硬化的相关性

<正>糖化血红蛋白(Hb A1c)是血红蛋白中糖基化的部分,作为糖尿病的诊断和治疗推荐指标之一,生理条件下的非酶促的糖基化过程是否可能导致动脉血管内皮的损害而造成早期的颈动脉内膜中层厚度(CIMT)增厚并导致以后的动脉粥样斑块的发生。本研究观察老年高血压患者Hb A1c水平与颈动脉粥样硬化相关性。1对象和方法1.1对象2007~2009年内分泌科、心内科和高血压科住院     

糖化血红蛋白与糖尿病诊断

2009年美国糖尿病学会科学年会上,由美国糖尿病学会（ADA）、欧洲糖尿病研究学会（EASD）和国际糖尿病联盟（IDF）组织的国际专家委员会一致推荐,将糖化血红蛋白（HbA1c）作为诊断糖尿病的新指标,该建议提出后在学术界引起热议。早在1997年糖尿病诊断与分类委员会的工作报告中已明确提出HbA1c与糖尿病视网膜病变之间存在显著相关性,但未将其作为糖尿病诊断手段的主要原因是HbA1c的检测尚未标准化,而近年来国际临床化学联盟（IFCC）开展的HbA1c检测国际标准化工作极大地推动了这次糖尿病诊断标准的变革。     

血清C肽、HbA1c水平联合检测诊断糖尿病的临床分析

选择2017年8月~2018年8月87例DM患者作为研究组,NDM患者87例作为对照组。结果观察组血清C肽、HbA_1c、FPG以及2hFPG水平高于对照组,(P<0.05);绘制ROC曲线结果显示血清C肽、HbA_1c及两者联合诊断糖尿病的AUC分别为:0.852、0.826、0.951,均> 0.80,诊断效能均较理想。结论 DM患者的血清C肽、HbA_1c呈高表达。     

老年糖尿病患者糖化血红蛋白水平与心血管功能的相关性

目的探讨老年糖尿病(DM)患者糖化血红蛋白(Hb A1c)水平与心血管功能的相关性。方法随机选择对照组44例,DM组50例。采集临床指标行统计分析。结果 1DM组空腹血糖(FPG)、Hb A1c、24 h脉压(24 h PP)、左室重量(LVM)和氨基末端B型利钠肽(NT-pro BNP)较对照组升高,夜间收缩压下降率(SBPF)、左室舒张早期与晚期二尖瓣最大血流速比值(E/A)和左室射血分数(LVEF)较对照组降低。2Hb A1c升高组24 h PP、LVM和NT-pro BNP较Hb A1c正常组升高,SBPF和LVEF较Hb A1c正常组降低。3所有入选者Hb A1c与24 h PP、LVM、NTpro BNP呈正相关,与SBPF、E/A、LVEF呈负相关。结论老年DM患者多表现心血管系统损害,在血糖控制欠佳时尤甚。Hb A1c应该作为评价DM治疗效果、预测患者心脑血管损害及指导预后的最重要指标。     

2型糖尿病住院患者糖化血红蛋白与果糖胺及空腹血糖的相关分析

目的分析住院T2DM患者HbA1c水平与FPG和果糖胺(FRU)之间的相关性。方法选取432例住院T2DM患者,按HbA1c水平分为<6.5%、6.5%～7.5%和>7.5%3组。分析各组HbA1c与FPG、FRU之间的相关性。结果 HbA1c<6.5%组,HbA1c与FPG和FRU之间无相关性(r=0.254,P=0.108;r=-0.032,P=0.884),TG与HbA1c呈正相关(r=0.342,P=0.031);6.5%～7.5%组,HbA1c与FPG和FRU之间无相关性(r=0.153,P=0.151;r=0.167,P=0.132),WHR与HbA1c呈正相关(r=0.230,P=0.035);>7.5%组,HbA1c与FPG和FRU呈正相关(r=0.522,P=0.000;r=0.770,P=0.000)。各年龄段患者(<65岁,65～80岁,>80岁)HbA1c与FPG和FRU之间均呈正相关(r=0.2193～0.2921,P<0.01;r=0.6525～0.7436,P<0.01)。结论住院的HbA1c<7.5%的T2DM患者,FPG、FRU与HbA1c水平无相关性,三指标间的一致性较差。     

C反应蛋白、糖化血红蛋白与尿mAlb对糖尿病肾病的诊断价值

目的：探讨C反应蛋白、糖化血红蛋白与尿微量白蛋白对早期诊断糖尿病肾病的价值。方法：采用速率散比浊法,离子交换高压液相色谱法检测了65例2型糖尿病患者与71例健康对照者体内的C反应蛋白、糖化血红蛋白与尿微量白蛋白的水平。结果：C反应蛋白、糖化血红蛋白与尿微量白蛋白的水平在2型糖尿病组高于健康对照组,差异有统计学意义。结论：联合检测糖尿病患者C反应蛋白、糖化血红蛋白与尿微量白蛋白有利于糖尿病肾病的早期检出,延缓糖尿病肾病的进展。     

C反应蛋白、糖化血红蛋白与尿mA1b对糖尿病肾病的诊断价值

目的:探讨C反应蛋白、糖化血红蛋白与尿微量白蛋白对早期诊断糖尿病肾病的价值.方法:采用速率散比浊法,离子交换高压液相色谱法检测了65例2型糖尿病患者与71例健康对照者体内的C反应蛋白、糖化血红蛋白与尿微量白蛋白的水平.结果:C反应蛋白、糖化血红蛋白与尿微量白蛋白的水平在2型糖尿病组高于健康对照组,差异有统计学意义.结论:联合检测糖尿病患者C反应蛋白、糖化血红蛋白与尿微量白蛋白有利于糖尿病肾病的早期检出,延缓糖尿病肾病的进展.     

Lipid peroxidation,antioxidants, lipid profile,and HbA1c in diabetic patients

Diabetes mellitus is characterized by hyperglycemia together with biochemical changes in glucose, lipid profile, lipid peroxidation, and antioxidants status. This study aims to assess lipid profile, lipid peroxidation, antioxidants, and glycated hemoglobin (HbA1c) in type 1 and type 2 diabetic subjects. Type 1 and type 2 diabetic patients were selected from the subjects attending OPD in Nepalgunj Medical College, Nepal, for medical checkup. Fasting blood sugar (FBS), lipid profile, lipid peroxidation (malondialdehyde), and antioxidants status (reduced glutathione and vitamin E) were estimated in both groups and were compared with healthy controls. Low-density lipoprotein (LDL)/high-density lipoprotein (HDL) ratio was calculated to assess the cardiovascular risk factors. When type 1 diabetic patients were compared with type 2 diabetic patients, it showed statistically significant increase in the levels of HbA1c, triglycerides (TGs), and high-density lipoprotein cholesterol (HDL-C), whereas statistically significant decreased level was found in malondialdehyde (MDA). FBS, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), reduced glutathione (GSH), vitamin E, and HDL/LDL ratio were not significant. Early diagnosis of dyslipidemia and oxidative stress can be used as a preventive measure for the development of microvascular and macrovascular complications in type 1 and type 2 diabetes mellitus.     

HbA1c is outcome predictor in diabetic patients with sepsis

We have investigated predictive value of HbA1c for hospital mortality and length of stay (LOS) in patients with type 2 diabetes admitted because of sepsis. A prospective observational study was implemented in a university hospital, 286 patients with type 2 diabetes admitted with sepsis were included. Leukocyte count, CRP, admission plasma glucose, APACHE II and SOFA score were noted at admission, HbA1c was measured on the first day following admission. Hospital mortality and hospital length of stay (LOS) were the outcome measures. Admission HbA1c was significantly lower in surviving patients than in non-survivors (median 8.2% versus 9.75%, respectively; P<0.001). There was a significant correlation between admission HbA1c and hospital LOS of surviving patients (r=0.29; P<0.001). Logistic regression showed that HbA1c is an independent predictor of hospital mortality (odds ratio 1.36), together with female sex (OR 2.24), APACHE II score (OR 1.08) and SOFA score (OR 1.28). Multiple regression showed that HbA1c and APACHE II score are independently related to hospital LOS. According to our results, HbA1c is an independent predictive factor for hospital mortality and hospital LOS of diabetic patients with sepsis.     

Aspirin resistance associated with HbA1c and obesity in diabetic patients

INTRODUCTION: Diabetes is known to be a prothrombotic state. Since serotonin uptake plays a role in both platelet activation and depression, we undertook to examine a hypothesis that aspirin resistance (AR) may be associated with both HbA1c and depressive symptoms and to assess other potential determinants of AR in diabetic patients. METHODS: A whole-blood desktop platelet function analyzer (PFA-100) with an epinephrine agonist was used to assess AR among patients with type 2 diabetes. AR was defined as PFA closure times <192 s. Depression symptoms were assessed with the Physicians Health Questionnaire. Patients being treated for type 2 diabetes (N=48) who took aspirin within the past 24 h constituted the study sample. Associations with AR were assessed with the use of the Mann-Whitney test and Fisher's Exact Test as well as with logistic regression models. RESULTS: AR was observed in 11 patients (23%) and was not significantly associated with age, sex, or race. AR was significantly associated with HbA1c > or = 8% (P=.002) and obesity (BMI> or = 30 kg/m(2); P=.01) and borderline associated with having > or = 1 depressive symptom (P=.07). Results were similar after multivariable adjustment in logistic regression models. No statistically significant associations of AR with age, sex, race, plasma glucose, blood pressure, cholesterol, or smoking were observed. CONCLUSION: These data suggest that AR may be of special concern for diabetic patients with poor glucose control and obesity. Whether the PFA-100 or any other practical measure of AR can be used in clinical practice to identify added cardiovascular disease risk and to inform platelet inhibition therapy needs further study.     

Serum HbA1c levels and exercise capacity in diabetic patients.

It is well known that cardiovascular morbidity and mortality are high in diabetic patients. Cardiac involvement is silent and early and these diabetic patients generally complain of chronic fatigue. This study was designed to evaluate the relation between glycemic control and exercise capacity in 330 diabetic patients who have no cardiac symptoms by sustaining dynamic exercise. After a cardiac examination, patients with coronary heart disease, ECG abnormalities, cardiac failure, valvular disease, cerebrovascular disease, peripheral artery disease, anaemia and peripheral neuropathy were excluded. Plasma HbA1c and lipid levels were obtained and a symptom limited exercise test based on "Bruce Protocol" was performed on all patients. Plasma HbA1c levels were significantly increased in smokers and in hypercholesterolemic patients (p<0.001, p=0.006). A moderate correlation between exercise capacity and HbA1c levels, and a weak correlation between duration of diabetes, age, sex, hypertension and plasma lipids were obtained. Multivariant regression analys is revealed that only HbA1c and hypercholesterolemia affected exercise capacity independently (r=-0.54 r=-0.30). In conclusion, poor glycemic control in diabetic patients causes earlier cellular involvement. Because of the high affinity of HbA1c to oxygen, the energy metabolism of the cell is affected, with a clinical correlation between chronic fatigue and worsening exercise capacity.     

The value of admission HbA(1c) level in diabetic patients with acute coronary syndrome

Background:

Elevated admission glucose level is a strong predictor of short‐term adverse outcome in patients with acute coronary syndrome (ACS). However, the prognostic value of diabetic control (ie, hemoglobin A_1c levels) in patients with ACS is still undefined.

Hypothesis:

Hemoglobin A_1c level may predict short‐term outcome in patients with ACS.

Methods:

We conducted a retrospective study with prospective follow‐up in 317 diabetic patients with ACS. Patients were stratified into 2 groups based on HbA_1c level, checked within 8 weeks of the index admission (optimal control group, HbA_1c ≤7%; suboptimal control group, HbA_1c >7%). All patients were followed up prospectively for major adverse cardiovascular events (MACE) and mortality for 6 months. Short‐term clinical outcomes were also compared between the 2 study groups.

Results:

In our cohort, 27.4%, 46.4%, and 26.2% patients had unstable angina, non–ST‐segment elevation myocardial infarction, and ST‐segment elevation myocardial infarction, respectively. In‐hospital mortality was similar in both HbA_1c groups (3.37% vs 2.88%, P = 0.803). Six‐month MACE was also similar (26.40% vs 26.47%, P = 0.919). All‐cause mortality, cardiovascular mortality, symptom‐driven revascularization, rehospitalization for angina, and hospitalization for heart failure were also similar in both groups. The hazard ratios for 6‐month MACE and individual endpoints were also similar in both groups.

Conclusions:

This study suggests that HbA_1c levels before admission are not associated with short‐term cardiovascular outcome in diabetic patients subsequently admitted with ACS. © 2011 Wiley Periodicals, Inc. The authors have no funding, financial relationships, or conflicts of interest to disclose.     

糖化血红蛋白用于筛查糖尿病的意义

目的比较并评价空腹血糖（FPG）和糖化血红蛋白（HbA1c）在筛查DM中的应用价值。方法上海地区研究对象2298名,为明确DM诊断而就诊者和DM高危人群接受DM筛查者,男956名,女1342名,年龄52±13岁,行OGTT并测定HbA1C;以其工作特征曲线（ROC）评价FPG和HbA。C在筛查DM中的敏感性和特异性。结果（1）按照1999年WHO的DM诊断标准,本研究人群糖耐量正常（NGT）、空腹血糖受损（IFG）、糖耐量受损（IGT）、IGT合并IFG和DM者分别为830、110、380、183、795例。其中DM患病率为34．6％。（2）依据ROC判断,与DM状态相关的FPG最佳临界点为6．1mmol／L,敏感性和特异性均为81．5％,曲线下面积为0．899（95％CI0．885～0．914）,阳性似然比4．18,阴性似然比0．23;与DM状态相关的HbA1c最佳临界点为6．1％,敏感性和特异性均为81．0％,曲线下面积为0．890（95％CI0．876-0．904）,阳性似然比4．26,阴性似然比0．23;如应用FPG≥6．1mmol／L或HbA1c≥6．1％筛查DM,敏感性和特异性分别为96．5％和65．2％,阳性似然比2．77,阴性似然比0．05。结论FPG和HbA1C在筛查DM中具有相似的价值,二者均有相似的特异性和敏感性以及阳性似然比和阴性似然比。为了最大限度的筛查出DM患者,建议对于6．1mmol／L≤FPG〈7．0mmol／L或HbA1c≥6．1％的患者行OGTT检查以明确有无DM。     

不同尿白蛋白水平的糖尿病患者单核细胞趋化蛋白-1和尿N-乙酰β-D-氨基葡萄糖苷酶的含量变化及其临床意义

目的观察不同尿白蛋白水平的糖尿病患者单核细胞趋化蛋白1(MCP1)和尿N乙酰βD氨基葡萄糖苷酶(NAG)的含量变化及其临床意义。方法将60例糖尿病患者按尿白蛋白排泄率(UAER)的不同分为正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组3组。分别测定血清和尿MCP1的含量、尿NAG含量以及血肌酐(Scr)、糖化血红蛋白(GHbAlc),进行组间比较,并与对照组比较,同时做尿MCP1与GHbAlc、UAER、NAG的相关分析。结果尿MCP1含量及NAG含量在所有患者中均升高,明显高于对照组,且大量白蛋白尿组升高最明显,其升高程度与尿白蛋白排泄率增高程度一致,即随糖尿病肾病加重而逐渐升高。而血清MCP1水平较低,与对照组比较无显著性差异;尿MCP1与GHbAlc、UAER、NAG呈正相关关系。结论尿中MCP1升高与糖尿病肾病的发生发展有密切关系,尤其与肾小管间质损伤有更密切的关系。     

老年糖尿病肾病患者临床护理干预效果分析

目的观察探讨老年糖尿病肾病患者的有效护理措施。方法以该院2012年3月—2014年11月,收治并确诊的97例糖尿病肾病患者,作为研究观察对象,对其运用心理护理和用药护理,以及透析护理等具有针对性的临床护理干预措施,并详细记录与分析其治疗疗效。结果经过系统化临床护理干预,97例研究对象中,患者血糖得到有效控制的有90例(92.8%),其余7例(7.2%)患者血糖偏高,则是未按医嘱用药所致。而全部患者中71例(73.2%)得到血液透析的患者,血尿素氮都在每升18 mmol/L以下,血肌酐也都控制在了每升395~440μmol;而下余26例(26.8%)患者:有6例(23.1%)患者由于多脏器衰竭死亡;有2例(7.7%)由于肾功能恶化引起病情加重;其他18例(69.2%)患者,则由经济原因没能进行持续性的血液透析。结论临床中对于糖尿病肾病患者的护理,除强化常规有针对性的饮食干预和透析,以及用药护理外,加强心理护理,对患者生存质量的提升和降低死亡率的意义重大。