糖化血红蛋白浓度的短期生物学变异

Short-term Biological Variation of Glycated Hemoglobin-A1c

目的研究糖化血红蛋白(glycated hemoglobin-A1c,HbA1c)浓度短期内的生物学变异。方法 30名健康志愿者在第1天、第3天和第5天的上午8∶00、中午12∶00和下午4∶00分别采集静脉血,进行HbA1c浓度的测定。分析计算HbA1c浓度的个体内变异(within-subject coefficient of variations,CVI)、个体间变异(between-subject coefficient of variations,CVG)、分析变异(analytical coefficient of variations,CVA)、个体指数(index of individuality,II)和参考变化值(reference change value,RCV)。结果总体、女性及男性CVI分别为1.39%、1.49%和1.32%;CVG分别为2.65%、2.33%和2.90%;CVA均为0.6%;II分别为0.5、0.6和0.5;95%RCV分别为4.22%、4.45%和4.02%;99%RCV分别为5.19%、5.86%和5.29%。HbA1c上午8∶00、中午12∶00和下午4∶00的日内变异差异无统计学意义(P=0.28);第1天、第3天和第5天的周内日间变异差异无统计学意义(P=0.31);男女性别间差异亦无统计学意义(P=0.18)。结论HbA1c浓度的日内和周内日间生物学变异很小,结果相对稳定,男性和女性之间亦无明显差异。

Objective To study the short-term biological variation of glycated hemoglobin-A1c（ HbA1c）.Methods Blood samples from 30 healthy volunteers [17 men and 13 women; aged 23- 34 years（ median,24years） ]were drawn at 8∶ 00 am,12∶ 00 pm,and 4∶ 00 pm each day for 3 days（ days 1,3 and 5）,and HbA1c values were measured in duplicate by high performance liquid chromatography（ Variant Ⅱ Yurbo Analyser,BioRad）. Results The within-subject coefficient of variations（ CVI） of total,male,and female subjects in this study were 1. 39%,1. 49%,and 1. 32%,respectively. The between-subject coefficient of variations（ CVG） of the three groups mentioned above were 2. 65%,2. 33%,and 2. 90%,respectively. The analytical coefficient of variations（ CVA） of these three groups were all 0. 6%. The index of individuality（ II） of the three groups were0. 5,0. 6,and 0. 5,respectively. The 95% probabilities of reference change value（ RCV） of the three groups were 4. 22%,4. 45%,and 4. 02%,respectively. The 99% probabilities of RCV were 5. 19%,5. 86%,and5. 29%,respectively. Furthermore,intra- and inter-day biological variations of HbA1cwere fairly constant among the population examined（ P = 0. 28,0. 31）,and no significant difference was observed between the male and female participants（ P = 0. 18）. Conclusions The short-term CVIand CVGof HbA1cin healthy individuals areminimal. The laboratory findings are quite constant and homogeneous for HbA1cin short term and between genders.