新发暴发型1型糖尿病中糖化白蛋白／HbA1C比值与血糖波动幅度的相关性研究

Correlation study on glycated albumin to HbA1C ratio and amplitude of glucose excursions in new-onset fulminant type 1 diabetes

入选2013～2014年于复旦大学附属中山医院首诊的1型糖尿病住院患者共33例，收集其临床资料进行数据统计分析。结果显示，33例患者中共有暴发型1型糖尿病（FTlDM）7例、急性起病型1型糖尿病（AT1DM）12例及缓慢进展型1型糖尿病（SPIDDM）14例。FT1DM患者空腹C肽、负荷后C肽水平低于其他2组患者，糖化白蛋白（GA）／HbA。平均血糖波动幅度（MAGE）高于其他2组患者，差异均存在显著意义（均P〈0．05）。对所有1型糖尿病患者进行Pearson相关分析，结果提示GA／HbA1C比值与空腹c肽、MAGE、最高最低血糖差（ABG）水平均显著相关（P〈0．05）；多元线性逐步回归分析提示GA／HbA。比值与MAGE、ABG独立相关（P〈0．05）。Logistic回归分析结果显示GA、HbAM、GA／HbA。与FT1DM均独立相关（P〈0．05）。

Thirty-three patients with new-onset type 1 diabetes from Zhongshan Hospital, Fudan University were recruited from 2013 to 2014. Relevant clinical data were collected for the statistical analysis. Among the 33 patients with type 1 diabetes, there were 7 with fulminant type 1 diabetes （FT1DM） , 12 acute onset type 1 diabetes （ ATIDM）, and 14 with slowly progressive type 1 diabetes （ SPIDDM）. The fasting and stimulated C-peptide levels were significantly lower while glycated albumin （GA）/HbA1C and mean amplitude of glucose excursions （MAGE） levels were significantly higher in FT1DM group compared with other two groups （ all P〈 0.05 ）. Pearson correlation analysis in all patients with type 1 diabetes revealed that GA/HbA1C was correlated with fasting C-peptide, MAGE, and difference of the peak blood glucose to the lowest blood glucose （ ABG ） levels （ all P 〈 0. 05 ）. Stepwise multivariate analysis showed that GA/HbA1C was independently correlated with MAGE and ABG （P〈0.05）. Logistic regression model indicated that GA, HbA1C, and GA/HbA1C were independently correlated with FT1DM.