GA、HbA1c及其比值在T2DM常见并发症中的应用价值研究

Study on the application value of GA,HbA1c and their ratio in common complications of T2DM

目的探讨糖化清蛋白(GA)、GA和糖化血红蛋白(HbA1c)比值(GA/HbA1c)与下肢痛性糖尿病周围神经病变及糖尿病足的关系。方法选择2021年1-9月于石家庄市第二医院住院的2型糖尿病(T2DM)患者中随机选取单纯T2DM 53例、T2DM合并下肢痛性周围神经病变(PDPN)56例和T2DM合并糖尿病足(DF)52例。比较组间一般资料及生化指标、血糖控制指标,分析GA、GA/HbA1c比值与各项差异指标的相关性,采用多因素Logistic回归分析GA、GA/HbA1c比值与PDPN、DF的关系。结果组间年龄、病程、空腹血糖(FBG)、平均血糖(eAG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(apoA1)、血红蛋白(Hb)、血细胞比容(HCT)、平均红细胞血红蛋白量(MCH)、超敏C反应蛋白(hs-CRP)、超氧化物歧化酶(SOD)、肌酐(Cr)、尿素氮(BUN)、GA、GA/HbA1c比值差异有统计学意义(P<0.05)。组间GA、GA/HbA1c比值呈逐渐升高趋势(P<0.05)。不同GA、GA/HbA1c比值水平DF患病率差异有统计学意义,DF患病率随GA、GA/HbA1c比值增大呈升高趋势(P<0.05)。多因素Logistic回归分析表明,在调整了性别、年龄、体质量指数(BMI)和病程等混杂因素后,GA是PDPN发病的危险因素,GA、GA/HbA1c比值是DF发病的危险因素。结论GA、GA/HbA1c比值检测对辅助诊断PDPN、DF具有重要价值。

Objective To investigate the relationship between glycosylated albumin(GA),GA and Glycated hemoglobin ratio(GA/HbA1c)and painful peripheral neuropathy in lower limbs of diabetes and Diabetic foot.Methods From January to September 2021,53 patients with type 2 diabetes alone(T2DM),56 patients with type T2DM combined with lower limb painful peripheral neuropathy(PDPN)and 52 patients with T2DM combined with Diabetic foot(DF)were randomly selected from the inpatients with type 2 diabetes in the Second Hospital of Shijiazhuang.Compare general data,biochemical indicators,and blood glucose control indicators between groups,analyze the correlation between GA,GA/HbA1c ratio,and various differential indicators,and use multiple factor logistic regression analysis to analyze the relationship between GA,GA/HbA1c ratio,PDPN,and DF.Results There were significant differences in age,course of disease,fasting blood glucose(FBG),mean blood glucose(eAG),high-density lipoprotein cholesterol(HDL-C),apolipoprotein A1,hemoglobin(Hb),hematocrit(HCT),mean corpuscular hemoglobin(MCH),hypersensitive C-reactive protein(hs-CRP),superoxide dismutase(SOD),creatinine(Cr),Blood urea nitrogen(BUN),GA,GA/HbA1c ratio between groups,the difference were statistically significant(P<0.05).GA and GA/HbA1c ratio increased gradually between groups,the difference was statistically significant(P<0.05).There were statistical differences in the incidence of DF among different levels of GA and GA/HbA1c ratio.The incidence of DF increases with the increase of GA or GA/HbA1c ratio,the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that after adjusting for confounding factors such as gender,age,body mass index BMI,and course of disease,GA was a risk factor for the onset of PDPN,while GA and GA/HbA1c ratio were risk factors for the onset of DF.Conclusion The detection of GA and GA/HbA1c ratio is of great value in assisting the diagnosis of PDPN and DF.