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

Relationship between blood glucose levels and HbA_1c in type 2 diabetes.

目的探讨2型糖尿病患者糖化血红蛋白(HbA1c)与全天不同时间血糖水平的关系。方法171例2型糖尿病患者检测三餐前30min、餐后2h及晚睡前共7次血糖水平,并计算平均血糖水平(MBG),同时测定HbA1c。按HbA1c水平不同将患者分为2组血糖控制尚可组(HbA1c≤7.5%)和控制差组(HbA1c>7.5%)。直线回归相关分析总体及各组HbA1c与MBG、全天7次血糖的相关性。结果MBG与HbA1c呈显著正相关(r=0.851,P<0.001),MBG=-0.70+1.30×HbA1c;HbA1c与全天7次血糖水平均呈正相关,逐步多元线形回归分析示HbA1c与空腹、晚餐后、午餐后及早餐后血糖相关。HbA1c≤7.5%组的HbA1c与晚餐后、午餐后及午餐前血糖相关,而HbA1c>7.5%组HbA1c与空腹、晚餐后、午餐后及早餐后血糖相关。结论HbA1c受全天平均血糖水平的影响,血糖控制尚可组晚餐后、午餐后及午餐前的血糖对HbA1c影响明显,而血糖控制差组空腹、晚餐后、午餐后及早餐后的血糖对HbA1c影响明显。

Objective To explone the relationship between HbAlc and blood glucose（BG） levels in patients with type 2 diabetes. Methods HbA1 c and corresponding seven-polnt capillary blood glucose profiles （ premeal, postmeal, and bedtime ） obtained in 171 patients with type 2 diabetes mellitus were analyzed to define the relationship between HbA1c and BG. Mean blood glucose （ MBG） was estimated by seven-point capillary blood glucose. Linear regression analysis was used to analyze the correlation of HbA1c and MBG as well as each point capillary blood glucose profile. Results MBG was positively correlated with HbA1 C, with MBG （ mmol/1 ） = - 0.70 ＋ 1.30 x HbA1c （r = 0. 851, P 〈 0. 001）. Among individual time points, postdinner BG, postlunch BG and prelunch BG showed higher correlations with HbA, c than fasting, postbreakfast, predinner and bedtime BG in patients with HbA1c≤7.5% ,but in patients with HbAc 〉7.5% ,fasting,postdinner,postlunch and postbreakfast BG showed higher correlations with HbA1c than prelunch,predinner and bedtime BG. Conclusion HbA1c is related to MBG. Postdinner, postlunch and prelunch BG have more significant effect on HbAt c in patients under suboptimal glycemic control, but fasting, postdinner, posdunch and postbreakfast BG have more significant effect on HbA1c in patients under poor glycemic control.