糖化白蛋白、糖化白蛋白与糖化血红蛋白比值临床应用初探

GA and GA/A1c ration in blood glucose monitoring in the third trimester in gestational diabetes mellitus

目的探讨在孕晚期妊娠期糖尿病（GDM）产妇中，糖化白蛋白（GA）、糖化白蛋白与糖化血红蛋白的比值（GA／A1c）作为血糖监测指标的临床应用价值。方法选取2014年6月至12月于中国医科大学附属盛京医院例行常规产科检查并在本院足月分娩、单胎、无其他合并症及并发症的妊娠期糖尿病产妇共323例，测定分娩前一周GA水平，计算GA／A1c，分析GA、GA／A1c与产妇体重指数（BMI）、血糖水平及新生儿出生体重间的关系。结果（1）GA与糖化血红蛋白（HbA1c）呈线性正相关（r=0．4，P〈0．001），直线回归方程为GA=5．9＋0．9HbA1c。（2）GA／A1c与BMI呈线性负相关（r=-0．1，P=0．03），直线回归方程为GA／A1c=2．2—0．008BMI。（3）HbA1c与出生体重呈线性正相关（r=0．2，P=0．01）。结论在孕晚期GDM产妇中，GA、GA/A1c可作为临床血糖监测及评估的新指标。

Objective To explore whether maternal glycated albumin （ GA）, the ratio of glycated albumin and hemoglobin A1c （GA/Ale ratio） could be better indicators applied in blood glucose monitoring in the third trimester in gestational diabetes mellitus （GDM）. Methods GA and HbA1 c were retrospectively analyzed within a week before delivery in 323 gravida with GDM who were under treatment or had a terminated pregnancy at Shengjing hospital affiliated to China Medical University. Other inclusion criteria were single gestation, full term （ gestational age ≥ 37 weeks）, and no other pregnancy-related complications （e. g. , pregnancy-induced hypertension）. GA/A1c ratio was calculated according to GA and HbA1c. Results （ 1 ） GA and HbAlc had a linear positive relationship （ r = 0.4, p 〈 0. 001 ） ; the linear regression equation was GA = 5.9 ＋ 0.9 HbAlc. （2） GA/Alc ratio had a linear negative relationship with BMI （r = - 0. 1, P = 0. 03）, and the linear regression equation was GA/A1c ratio = 2.2-0.008 BMI. （3） HbA1c had significant correlation with neonatal birth weight （ r = 0.2, P = 0.01 ）. Conclusion In the last trimester of pregnancy, G A, GA/A1c ratio could be used to evaluate glucose control in GDM patients.