糖化白蛋白和糖化血红蛋白在T2DM合并血管病变早期诊断中的作用

The significance of glycated albumin and glycosylated hemoglobin in the early diagnosis of type 2 diabetes mellitus combined with vasculopathy

目的探讨糖化血红蛋白(HbA_(1c))与糖化白蛋白(GA)在2型糖尿病(T2DM)合并血管病变早期诊断中的检测意义。方法选择2013年7月~2016年7月南京医科大学附属江宁医院内分泌科收治的T2DM患者128例作为研究对象,其中T2DM合并血管病变(A组)65例,T2DM无血管病变(B组)63例,选择同期68例健康者作为对照组(C组)。检测3组的HbA_(1c)与GA水平并进行统计分析。结果 A组、B组的HbA_(1c)值、GA值均高于C组,差异有高度统计学意义(P<0.001);而A组的HbA_(1c)值、GA值与B组比较,差异无统计学意义(P>0.05)。受试者工作曲线(ROC曲线)分析显示,A组与C组的HbA_(1c)值ROC曲线下面积为0.980,最适cutoff值为6.55 mmol/L时,敏感度为95.38%,特异度为91.56%。B组与C组HbA_(1c)值ROC曲线下面积为0.981,最适cutoff值为6.50 mmol/l时,敏感度为95.24%,特异度为91.80%。A组与C组的GA值ROC曲线下面积为0.965,最适cutoff值为15.65 mmol/时,敏感度为95.45%,特异度为96.72%。B组与C组的GA值ROC曲线下面积为0.930,最适cutoff值为15.70 mmol/L时,敏感度为88.89%,特异度为96.89%。结论 T2DM合并血管病变患者的GA、HbA_(1c)水平相较于健康人群明显升高,但T2DM与T2DM合并血管病变的GA和HbA_(1c)水平并无明显区别,因此这两项指标对于T2DM合并血管病变的早期诊断并无显著作用。

Objective To investigate the significance of glycosylated hemoglobin（HbA1c） and glycated albumin（GA） in the early diagnosis of type 2 diabetes mellitus（T2 DM） combined with vasculopathy. Methods From July 2013 to July 2016,128 cases of patients with type 2 diabetes mellitus in Department of Endocrinology, the Affiliated Jiangning Hospital of Nanjing Medical University were selected as the research objects, which including 65 cases of patients with type 2 diabetes mellitus complicated with vasculopathy（group A） and 63 cases of patients with type 2 diabetes mellitus without vasculopathy（group B）. At the same time 68 cases of healthy people were selected as control group（group C）. The levels of HbA1cand GA in the 3 groups were detected and the differences of the indicators in the 3 groups were statistically analysed. Results The values of HbA1cand GA in group A and group B were all higher than those of group C, with highly statistically significant differences（P 〈 0.001）, but there were no statistically significant differences between group A and group B（P 〉 0.05）. The receiver operating characteristic curve（ROC curve） showed that the area under the ROC curve of HbA1cof group A and group C was 0.980, the most suitable cutoff value was 6.55 mmol/L, the sensitivity was 95.38% and the specificity was 91.56%. The area under the ROC curve of HbA1cof group B and group C was 0.981, the most suitable cutoff value was 6.50 mmol/L, the sensitivity was 95.24% and the specificity was 91.80%.The area under the ROC curve of GA of group A and group C was 0.965, the most suitable cutoff value was 15.65 mmol/L,the sensitivity was 95.45% and the specificity was96.72%. The area under the ROC curve of GA of group B and group C was 0.930, the most suitable cutoff value was 15.70 mmol/L, the sensitivity was 88.89% and the specificity was 96.89%. Conclusion The levels of GA and HbA1cin patients with T2DM combined with vasculopathy are significantly higher than those of healthy people, while there are no significant differences in GA and HbA1cbetween T2DM and T2DM combined with vasculopathy. Therefore, the detection of GA and HbA1c have no effect on the early diagnosis of T2DM combined with vasculopathy.