糖化白蛋白和糖化血红蛋白在T2DM合并血管病变早期诊断中的作用

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摘要目的探讨糖化血红蛋白（HbA1c）与糖化白蛋白（GA）在2型糖尿病（T2DM）合并血管病变早期诊断中的检测意义。方法选择2013年7月～2016年7月南京医科大学附属江宁医院内分泌科收治的T2DM患者128例作为研究对象，其中T2DM合并血管病变（A组）65例，T2DM无血管病变（B组）63例，选择同期68例健康者作为对照组（C组）。检测3组的HbA1c与GA水平并进行统计分析。结果 A组、B组的HbA1c值、GA值均高于C组，差异有高度统计学意义（P ＜ 0.001）；而A组的HbA1c值、GA值与B组比较，差异无统计学意义（P ＞ 0.05）。受试者工作曲线（ROC曲线）分析显示，A组与C组的HbA1c值ROC曲线下面积为0.980，最适cutoff值为6.55 mmol/L时，敏感度为95.38%，特异度为91.56%。B组与C组HbA1c值ROC曲线下面积为0.981，最适cutoff值为6.50 mmol/l时，敏感度为95.24%，特异度为91.80%。A组与C组的GA值ROC曲线下面积为0.965，最适cutoff值为15.65 mmol/时，敏感度为95.45%，特异度为96.72%。B组与C组的GA值ROC曲线下面积为0.930，最适cutoff值为15.70 mmol/L时，敏感度为88.89%，特异度为96.89%。结论 T2DM合并血管病变患者的GA、HbA1c水平相较于健康人群明显升高，但T2DM与T2DM合并血管病变的GA和HbA1c水平并无明显区别，因此这两项指标对于T2DM合并血管病变的早期诊断并无显著作用。

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	张美王欢徐勇李艳陈莉彭启松▲

关键词 ：糖化血红蛋白, 糖化白蛋白, 2型糖尿病, 血管病变

Abstract：Objective To investigate the significance of glycosylated hemoglobin (HbA1c) and glycated albumin (GA) in the early diagnosis of type 2 diabetes mellitus (T2DM) combined with vasculopathy. Methods From July 2013 to July 2016, 128 cases of patients with type 2 diabetes mellitus in Department of Endocrinology, the Affiliated Jiangning Hospital of Nanjing Medical University were selected as the research objects, which including 65 cases of patients with type 2 diabetes mellitus complicated with vasculopathy (group A) and 63 cases of patients with type 2 diabetes mellitus without vasculopathy (group B). At the same time 68 cases of healthy people were selected as control group (group C). The levels of HbA1c and GA in the 3 groups were detected and the differences of the indicators in the 3 groups were statistically analysed. Results The values of HbA1c and GA in group A and group B were all higher than those of group C, with highly statistically significant differences (P ＜ 0.001), but there were no statistically significant differences between group A and group B (P ＞ 0.05). The receiver operating characteristic curve (ROC curve) showed that the area under the ROC curve of HbA1c of group A and group C was 0.980, the most suitable cutoff value was 6.55 mmol/L, the sensitivity was 95.38% and the specificity was 91.56%. The area under the ROC curve of HbA1c of group B and group C was 0.981, the most suitable cutoff value was 6.50 mmol/L, the sensitivity was 95.24% and the specificity was 91.80%. The area under the ROC curve of GA of group A and group C was 0.965, the most suitable cutoff value was 15.65 mmol/L, the sensitivity was 95.45% and the specificity was 96.72%. The area under the ROC curve of GA of group B and group C was 0.930, the most suitable cutoff value was 15.70 mmol/L, the sensitivity was 88.89% and the specificity was 96.89%. Conclusion The levels of GA and HbA1c in patients with T2DM combined with vasculopathy are significantly higher than those of healthy people, while there are no significant differences in GA and HbA1c between T2DM and T2DM combined with vasculopathy. Therefore, the detection of GA and HbA1c have no effect on the early diagnosis of T2DM combined with vasculopathy.

Key words： Glycated albumin Glycosylated hemoglobin Type 2 diabetes mellitus Vasculopathy

基金资助:江苏省南京市江宁区科技发展计划项目（2015 E117）。

通讯作者: ▲通讯作者

引用本文:

张美王欢徐勇李艳陈莉彭启松▲. 糖化白蛋白和糖化血红蛋白在T2DM合并血管病变早期诊断中的作用[J]. 中国医药导报, 2018, 15(12): 41-44.
ZHANG Mei WANG Huan XU Yong LI Yan CHEN Li PENG Qisong▲. The significance of glycated albumin and glycosylated hemoglobin in the early diagnosis of type 2 diabetes mellitus combined with vasculopathy. 中国医药导报, 2018, 15(12): 41-44.

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[1] 童南伟.中国成人2型糖尿病HbA1c控制目标的专家共识解读[J].中国实用内科杂志，2011，27（5）：371-374.
[2] 周翔海，纪立农.空腹血糖和糖化血红蛋白用于筛查糖尿病的研究[J].中华糖尿病杂志，2005，13（3）：203-205.
[3] 郑玲，刘秋爽，金晶，等.糖尿病并发症治疗靶点的研究进展[J].海峡药学，2014，26（1）：13-17.
[4] 黄琼刁，邓万溪，黄钦展，等.糖尿病主要并发症年龄与体质之相关性研究[J].世界中医药，2013，8（3）：288-290.
[5] 荆爱玉，袁晓红，倪红艳，等.糖化血红蛋白在诊断2型糖尿病中的价值[J].西安交通大学学报：医学版，2012， 33（5）：306-308.
[6] 金先富，沈波，王静，等.评价糖化白蛋白在糖尿病患者短期血糖监测中的价值[J].中国临床药理学杂志，2011， 27（4）：302-305.
[7] Word Health Organization Definition. Diagnosis and classification of diabetes mellitus and its complication partl，diagnosis and classification of diabetes mellitus [M]. Geneva：World Health Organization，1999.
[8] 李顺斌，郑淑莺，邱蔚，等.2型糖尿病合并大血管病变的危险因素分析[J].中国现代医生，2010，48（29）：25-26.
[9] 叶向，杨洋，时霞飞.C反应蛋白和尿酸与2型糖尿病周围血管病变间的关系分析[J].现代中西医结合杂志，2013， 22（30）：3310-3312.
[10] 刘洁，王尧.血糖波动与糖尿病并发症的关系[J].现代学，2010，38（2）：200-203.
[11] 陆林，蒲里津，张奇，等.2型糖尿病患者血清糖化白蛋白水平与冠状动脉病变程度的关系[J].中国循环杂志，2007，22（5）：343-346.
[12] 刘树娇，唐灵，陈春莲，等.2型糖尿病肾病患者内脂素、同型半胱氨酸和高敏C-反应蛋白变化及临床意义[J].河北医药，2014，34（8）：1125-1127.
[13] 齐凤琴，吴军凯，于丹，等.葛根素治疗糖尿病并发症的药理作用及机制[J].哈尔滨商业大学学报：自然科学版，2012，28（3）：267-270.
[14] 黄敬泽，王健.2型糖尿病糖化血红蛋白与全天不同时间血糖水平的关系[J].中国综合临床，2006，22（12）：1101-1103.
[15] 张健，杨青，张进安，等.糖化血红蛋白在高危人群诊断2型糖尿病中的价值[J].西安交通大学学报：医学版，2010，31（4）：512-514.
[16] 赵咏莉，叶山东，陈月平，等.糖化血红蛋白对2型糖尿病患者脂代谢及其并发症影响的研究[J].中国糖尿病杂志，2013，21（2）：157-159.
[17] Raj S，Rajan GV. Correlation between elevated serum ferritin and HbA1c in type 2 diabetes mellitus [J]. Inter J Res Med Sci，2013，1（1）：12.
[18] Aizawa N，Enomoto H，Imanishi H，et al. Elevation of the glycated albumin to glycated hemoglobin ratio during the progression of hepatitis C virus related liver fibrosis [J]. World J Hepatol，2012，4（1）：11-17.
[19] 祁瑞芳.糖化白蛋白、超敏C-反应蛋白在2型糖尿病合并冠心病中的检测意义[J].西部中医药，2015，28（6）：154-155.
[20] Cui Y，Bu H，Ma X，et al. The Relation between Serum Uric Acid and HbA1c Is Dependent upon Hyperinsulinemia in Patients with Newly Diagnosed Type 2 Diabetes Mellitus [J]. J Diabetes Res，2016，2016（2）：1-6.