平均葡萄糖水平和HbA1c之间的关系在不同种族群体之间存在差异:GRADE随机试验的子研究
David M Nathan1, William H Herman2, Mary E Larkin1
1Diabetes Clinical Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Diabetes care
|September 23, 2024
概括
平均葡萄糖和HbA1c之间的联系因种族而异. 与非西班牙裔白人相比,非西班牙裔黑人个人在给定的平均葡萄糖水平上具有更高的HbA1c,这影响了糖尿病管理目标.
科学领域:
- 内分泌学 在内分泌学.
- 糖尿病研究研究 糖尿病研究
- 临床化学 临床化学
背景情况:
- 血红蛋白A1c (HbA1c) 是长期血糖控制的关键标志物.
- 以前的研究表明,HbA1c准确度可能存在种族/民族差异.
- 了解这些差异对于公平的糖尿病护理至关重要.
研究的目的:
- 调查平均葡萄糖 (AG) 和HbA1c之间的关系是否在种族/族群之间有所不同.
- 评估种族对血糖监测指标的影响及其与HbA1c的相关性.
主要方法:
- 涉及1454名参与者的GRADE试验的前性副研究.
- 使用10天连续血糖监测 (CGM) 来计算平均血糖 (AG10).
- 测量HbA1c,糖性白蛋白,快餐血葡萄糖 (FPG) 和曲线下的葡萄糖面积 (AUC).
主要成果:
- 在非西班牙裔黑人 (NHB) 和非西班牙裔白人 (NHW) 之间,AG10和HbA1c之间的关系显著不同.
- NHB患者的HbA1c水平比NHW患者高 (0.2-0.6个百分点),而类似的AG10水平 (100-250毫克/分升).
- 在调整人口统计和其他因素后,这些种族差异仍然存在.
结论:
- 包括平均葡萄糖,禁食血葡萄糖和葡萄糖AUC在内的葡萄糖测量显示,在不同种族群体中,与HbA1c和糖性白蛋白的关系始终不同.
- 这些发现需要在为不同人群制定糖尿病治疗目标和诊断标准时加以考虑.
- 强调需要对血糖控制标志物的种族意识的解释.
相关概念视频
Diabetes: Symptoms, Diagnosis, and Complications
516
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
516
Diabetes Mellitus: Type 2 and Gestational
2.2K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.2K
Glucose Homeostasis: Regulation of Blood Glucose
1.5K
Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels stimulate the secretion of insulin from the pancreas. Insulin inhibits hepatic glucose production and stimulates glucose uptake and metabolism by muscle and adipose tissue. The excess glucose is converted into glycogen and stored in the liver and muscles.
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
1.5K
Hypoglycemia and Glucagon
207
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
207
Hormones Regulating Blood Glucose
3.1K
Insulin is released by beta cells of the pancreas when blood glucose levels are high. It facilitates glucose absorption and utilization in insulin-dependent cells with insulin receptors on their plasma membranes. Insulin promotes glucose uptake by increasing the number of glucose transport proteins in the cell membrane, allowing glucose to enter the cell. As a result, glucose utilization and ATP production are enhanced.
In addition to accelerating glucose uptake and utilization, insulin has...
In addition to accelerating glucose uptake and utilization, insulin has...
3.1K
Regression Toward the Mean
6.3K
Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when...
6.3K


