174例糖耐量正常人群HbA_1c结果分析

The analysis of glycated hemoglobin(HbA_1c) values in 174 normal glucose tolerance population

目的分析HbA_1c在糖耐量正常(NGT)人群中的分布特点及相关因素。方法对健康体检和糖尿病筛查者进行75g OGTT试验,同时检测HbA_1c、血尿常规、FPG、2hPG及血生化,所有参加者进行人体学测量。将174名NGT人群的结果纳入分析,比较HbA_1c在不同性别及年龄组间的差异,用线性回归方法分析HbA_1c与年龄、FPG和2hPG的相关性;根据HbA_1c结果分为≤5.6%和5.7%～6.4%两组,比较两组的临床特点。结果 NGT人群的HbA_1c呈正态分布,结果是(5.62±0.38)%,95%CI为4.88%～6.36%;不同性别间HbA_1c无统计学差异;青年组(16～44岁)的HbA_1c及FPG分别与中年组(45～59岁)和老年组(60～79岁)间均有统计学差异(P<0.01),而2hPG无统计学差异;HbA_1c≤5.6%和5.7%～6.4%组的年龄、血TG水平、FPG和2hPG均有统计学差异(P<0.01或P<0.05)。结论应建立本实验室HbA_1c的正常参考值范围;NGT人群的HbA_1c随年龄的增长而升高,并与FPG呈正相关;处于高危HbA_1c范围的非糖尿病人群应加强对FPG、2hPG和TG的监测。

Objective To analyze the results of glycated hemoglobin measurement and related factors in normal glucose tolerance population. Methods A 75 g oral glucose tolerance test （OGTT） was administered to health check-up subjects and diabetes screening population. HbA1 c detecting, regular hemotology test, urine test, fasting plasma glucose （FPG）, 2 hours plasma glucose （2hPG） and blood biochemical test were conducted. Anthropometric measurements were performed to all the subjects. A total of 174 individuals with normal FPG and 2hPG were included for data analysis. Linear regression method was used to analyze the correlation of HbA1c to age , FPG and 2hPG, respectively. Reference range of HbA1 c was determined by 95% confidence interval for the mean Hh1c. All the subjects were divided into two groups： HbA1c 45.6% group and ≥5. 7-6. 4% group, and the clinical characteristics were compared between the two groups. Results HbA1 c was normally distributed in our study population. The mean of HbA1c was 5.62% （SD 0.38%）. The reference range was 4. 88% -6.36%. There was no difference in HbA1c between male and female subjects （P〉0. 05）. While a significant difference in HbA1 c and FPG was found between age groups. Age, FPG , 2hPG and TG were statistically different （P〈0. 01 or P〈0.05） between HbA1 c≤5.6% and ≥5.7%0-6.4% groups. Conclusions Each laboratory should make its own reference range of HbA1 c test. HbA1 c is positively correlated with age and FPG in the population with normal glucose tolerance. The non-diabetic population with high risk HbA1c value should monitor FPG , 2hPG and serum triglyceride more frequently.