使用可变HbA1c作为查工具,以尽量减少对HbA1c的临床误解
Emilie De Muynck1, Bruno Lapauw2, Joris Delanghe1
1Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.
Clinical chemistry and laboratory medicine
|December 12, 2024
概括
L-HbA1c/HbA1c比率有助于确定何时血红蛋白A1c (HbA1c) 结果可能不准确地反映患者的平均血糖. 这一比率是临床医生在日常糖尿病护理中解释HbA1c值的宝贵工具.
科学领域:
- 临床化学 临床化学
- 内分泌学 在内分泌学.
- 糖尿病研究研究 糖尿病研究
背景情况:
- 血红蛋白A1c (HbA1c) 对于糖尿病管理至关重要,但由于生物变异,可能会被误解.
- 非稳定状态条件和个体患者因素可能会影响HbA1c的准确性.
研究的目的:
- 评估L-HbA1c/HbA1c比率作为标记潜在误导性HbA1c结果的方法.
- 评估该比率是否可以识别与预期的血糖控制不一致的HbA1c值.
主要方法:
- 通过使用Tosoh G8分析仪对450名患者样本进行分析,根据L-HbA1c/HbA1c比率 (高,低,正常) 分类.
- 相关的HbA1c与糖分标记物,如果糖胺和随机葡萄糖跨比例组.
- 在1型糖尿病患者的小组中使用了持续的葡萄糖监测.
主要成果:
- 在比例组之间观察到HbA1c与血糖相关性的显著差异.
- 高L-HbA1c/HbA1c比率表明随机葡萄糖和果糖胺水平较高,表明HbA1c被低估.
- 该比率显示了82%的灵敏度和65%的特异性,用于预测低于-1.5NGSP单位的糖化差距.
结论:
- 在临床实践中,L-HbA1c/HbA1c比率是解释HbA1c结果的有用辅助.
- 这个比率有助于识别可能不准确地反映患者的血糖状况的HbA1c值.
相关概念视频
Hypoglycemia and Glucagon
152
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...
152
Diabetes: Symptoms, Diagnosis, and Complications
504
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...
504


