2型糖尿病血液透析患者GA／HbAlc与营养状况的相关性

Relationship between glycated albumin/HbAlc ratio and nutritional status in type 2 diabetic patients sub-ject to hemodialysis

目的探讨2型糖尿病血液透析患者糖化白蛋白（GA）与糖化血红蛋白（HbAlc）的比率和营养状况指标间是否存在相关性。方法选择2型糖尿病血液透析患者20例，根据患者GA／HbAlc值（3．35）分为低G_A／HbAlc值组（A组，〈3．35），高GA／HbAlc值组（B组，2〉3．35），测定与营养状况相关的指标：时间平均尿素浓度（TACurea）、整体尿素清除指数（Kt／V）、蛋白质分解代谢率（PCR）、血清铁、转铁蛋白饱和度（TS）、铁蛋白（sF）、总蛋白（TP）、白蛋白（Alb）、总胆固醇（TC）、甘油三酯（TG）、血红蛋白（Hb）、血细胞比容（Hct）、血钙、血磷、碱性磷酸酶（ALP）、GA和HbAlc，分析GA／HbAlc值与上述指标的相关性。结果B组体质量指数（BMI）、PCR及血磷明显低于A组（P〈0．05）。此外，在所有患者中GA／HbAlc值与BMI、PCR及血磷呈负相关（r=一0．713、一0．576、一0．597，P％0．05）。结论本研究表明GA／HbAlc值营养状况指标关系密切，可能作为2型糖尿病血液透析患者营养状况评价的指标。

Objective To study the relationship between the glycated albumin （GA）/HbAlc ra- tio and nutritional status in patients with type 2 diabetes mellitus （T2DM） receiving hemodialysis. Methods Twenty cases of T2DM receiving hemodialysis （13 males and 7 females） were chosen, and divided into two groups according to the mean value of GA/HbAlc ratio （3. 35） . low GA/HbAlc ra- tio group （group A, GA/HbAlc ratio 〈3. 35） and high GA/HbAlc ratio group （group B, GA/ HbAlc ratio 〉3. 35）. The parameters related to nutritional status were determined.. BMI, TACurea, Kt/V, PCR, serum Fe,TS, SF, TP, Alb, TC, TG, Hb, Hct, blood calcium and phosphorus, ALP, GA and HbAlc. The correlation between GA/HbAlc ratio and nutritional status-related parameters above was analyzed. Results BMI, PCR and blood phosphorus levels in group B were significantly lower than in group A （P〈0. 05）. Among all patients, GA/HbAlc ratio was negatively correlated with BMI, PCR and blood phosphorus levels （r = - 0. 713, - 0. 576 and - 0. 597 respectively,P〈0. 05）. Conclusions The GA/HbAlc ratio may be useful as one of nutritional parameters in patients with T2DM receiving hemodialysis.