2型糖尿病患者糖化血清白蛋白水平临床意义及影响因素

Clinical significance and influential factors of glycated albumin in patients with type 2 diabetes mellitus

目的评价糖化血清白蛋白(glycated albumin,GA)作为反映住院患者短期血糖控制及变化指标的可靠性。方法301例2型糖尿病患者,检测并比较入院第1天和住院第12天空腹血糖(fasting plasma glucose,FPG)、餐后2h血糖(2-hour postprandial plasma glucose,2hPG),1d指尖血糖谱均值(mean amplitude of glucose,MBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)和GA值,分析GA与2hPG、MBG和HbA1c的相关性。结果 301例患者入院后第1天FPG水平为(11.85±8.33)mmol/L,2hPG为(15.43±5.48)mmol/L,MBG为(13.16±4.36)mmol/L,GA为(36.91±8.18)%,住院后第12天分别为(6.95±1.82)mmol/L、(9.27±2.48)mmol/L、(8.64±1.76)mmol/L、(25.66±7.35)%,差异有统计学意义(P<0.05);GA与2hPG(r=0.506,P=0.024)、MBG(r=0.744,P=0.040)及HbA1c(r=1.659,P=0.000)均呈正相关。结论 GA可准确、及时反映住院短期内血糖水平的变化,较HbA1c更适合作为评价2型糖尿病患者住院期间(12d)降糖疗效的临床监测指标。

Objective To assess the reliability of glycated albumin（GA）as a clinical marker for monitoring plasma glucose controlling in short term and its changes in inpatients with type 2diabetes mellitus（T2DM）.Methods A total of301T2 DM inpatients were detected the changes of fasting plasma glucose（FPG）,2-hour postprandial plasma glucose（2hPG）,mean amplitude of glucosa（MBG）,glycosylated hemoglobin（HbA1c）and GA levels on the 1st and 12 th days after admission respectively.Results The FPG level was（11.85±8.33）mmol/L,2hPG was（15.43±5.48）mmol/L,MBG was（13.16±4.36）mmol/L,and GA was（36.91±8.18）% on the 1st day after admission,significantly different from those on the 12 th day（（6.95±1.82）mmol/L,（9.27±2.48）mmol/L,（8.64±1.76）mmol/L,（25.66±7.35）%）（P〈0.05）.GA was positively correlated with 2hPG（r=0.506,P=0.024）,MBG（r=0.744,P=0.040）and HbA1c（r=1.659,P=0.000）.Conclusion GA can accurately and timely reflect the change of plasma glucose in short term,and is superior to HbA1 c for monitoring the plasma glucose controlling on the 12 th day after admission for T2 DM patients.