葡萄糖-6-磷酸脱氢酶缺乏与糖化血红蛋白的关系

The relationship of glucose-6-phosphate dehydrogenase deficiency and Hemoglobin A1c

目的通过对4组不同人群的葡萄糖-6-磷酸脱氢酶(G6PD)活性和糖化血红蛋白(HbA1c)测定结果进行统计分析,探讨G6PD缺乏与HbA1c的关系。方法选取2012年8月至2014年10月期间来该院进行健康体检者171例作为对照组;同时期该院确诊且符合WHO诊断标准的2型糖尿病患者195例(合并G6PD缺乏者7例)及G6PD缺乏患者73例(合并2型糖尿病者9例),分别设为糖尿病组188例,单纯G6PD缺乏组64例,糖尿病伴G6PD缺乏组16例。分别测定HbA1c、G6PD活性、空腹血糖(FBG)、间接胆红素(IBIL)、红细胞计数(RBC)、血红蛋白(HGB)水平并进行统计分析。结果与对照组相比,单纯G6PD缺乏组HbA1c值、RBC、HGB结果均偏低,差异具有统计学意义(P<0.05);与糖尿病组相比,糖尿病伴G6PD缺乏组HbA1c值、RBC、HGB结果均偏低,IBIL结果偏高,差异均具有统计学意义(P<0.05)。对照组及糖尿病伴G6PD缺乏组G6PD活性与HbA1c水平不具有相关性,糖尿病组G6PD活性与其HbA1c水平呈负相关(r=-0.161,P=0.033),单纯G6PD缺乏组G6PD活性与其HbA1c水平呈正相关(r=0.324,P=0.005);单纯G6PD缺乏组HbA1c水平与FBG无相关性,糖尿病伴G6PD缺乏组的HbA1c水平与FBG呈正相关但其HbA1c水平与真实HbA1c水平及相应的FBG水平不相符。结论G6PD缺乏导致HbA1c测定结果假性偏低,造成HbA1c水平与真实FBG水平不符。单纯G6PD缺乏者的HbA1c水平随G6PD活性增高而增高,糖尿病组HbA1c水平随G6PD活性降低而增高。

Objective To discuss the relationship between G6PD deficient and HbA1c ,we statistical and analysis the G6PD ac‐tivity and HbA1c measured results between four groups .Methods Chosen 171 cases of healthy controls in our hospital from Au‐gust 2012 to October 2012 as normal control group .195 cases patients who diagnosised as type 2 diabetes（7 cases combined with G6PD deficient） and 73 patients with G6PD deficient（9 cases combined with type 2 diabetes） were divided into three groups ：188 cases of diabetes group ,64 cases G6PD deficient group ,16 cases of diabetes combined with G6PD deficient group .Determination and statistical analysis their HbA1c ,G6PD activity ,fasting blood glucose（FBG） ,indirect bilirubin（IBIL） ,red blood cell count（RBC） , hemoglobin（HGB） content .Results Compared with normal control group ,the results of HbA1c values ,RBC ,HGB were low in G6PD deficient group ,the differences were significant （P〈 0 .05）;Compared with diabetes group ,the results of HbA1c values , RBC ,HGB are low in diabetes combined with G6PD deficient group ,however the IBIL result was high ,the differences were signifi‐cant（P〈0 .05） .Normal control group′s and diabetes combined with G6PD deficient group′s G6PD activity and HbA1c level was not relevant .G6PD activity and HbA1c level in diabetes group has a significant negative correlation （r= -0 .161 ,P=0 .033） ,G6PD activity and HbA1c level in G6PD deficiency group had a significant positive correlation （r= 0 .324 ,P= 0 .005）;G6PD deficient group′s HbA1c level and FBG had no relevance ;HbA1c levels and FBG had a significant positive correlation in the diabetes group who with G6PD deficiency ,however ,the HbA1c levels didn′t matched the real HbA1c levels and the corresponding FBG levels . Conclusion G6PD deficiency caused HbA1c determination result false low ,which leads HbA1c level don′t matched the real HbA1c level and the corresponding FBG level .G6PD deficient group′s HbA1c level increased with G6PD activity′s increase .Diabetes com‐bined with G6PD deficient group′s HbA1c level has no relevance with G6PD activity .Diabetes group′s HbA1c level increased with G6PD activity′s decrease .