Association of GA/HbA1c Ratio with Diabetic Retinopathy

Objectives: The aim of this study was to explore the potential correlation between the GA/HbA1c ratio and diabetic retinopathy (DR) in patients with type 2 diabetes (T2D), as the GA/HbA1c ratio serves as a marker for glycemic variability. Methods: A total of 2565 T2D patients were included in this study and grouped into five categories based on the diagnostic criteria for DR. We examined the impact of the GA/HbA1c ratio on the progression of diabetes. Results: The non-DR group exhibited lower GA/HbA1c levels compared to the DR group. Additionally, as the severity of DR increased among the five groups, there was a corresponding increase in the GA/HbA1c ratio. Logistic regression analysis demonstrated that the GA/HbA1c ratio independently elevated the risk of DR occurrence. Conclusions: The GA/HbA1c ratio can independently predict the occurrence and progression of diabetic retinopathy.

FPG、GA、HbA1c及GA/HbA1c比值在T1DM/T2DM中的诊疗价值

目的:探讨空腹血糖(FPG)、糖化清蛋白(GA)、糖化血红蛋白(HbA1c)及GA/HbA1c比值在1型糖尿病(T1DM)和2型糖尿病(T2DM)中的诊疗价值。方法:采用病例对照研究。以30例健康体检人群为正常对照组,以临床明确诊断的160例糖尿病患者为研究病例组,其中1型糖尿病(T1DM)组为76例、2型糖尿病(T2DM)组为84例,应用SPSS软件进行独立样本t检验、绘制受试者工作曲线(ROC曲线)及Pearson相关性检验,统计分析对照组与病例组,T1DM及T2DM组各组间FPG、GA及HbA1c的检测结果的相关性、GA/HbA1c比值及诊断切点的差异。结果:T1DM及T2DM组FPG、GA及HbA1c的检测结果及GA/HbA1c比值均明显高于对照组,且T1DM组高于T2DM组,P值均<0.01;T1DM组中HbA1c与GA成显著性正相关(P<0.01),FPG与GA呈弱正相关(P>0.05)、与HbA1c呈弱负相关(P>0.05);T2DM组中FPG、GA及HbA1c均成正相关(P值均<0.05),相关程度依次为HbA1c/GA>FPG/GA>FPG/HbA1c;评估各指标的ROC曲线分析:T1DM组中,FPG、GA、HbA1c及GA/HbA1c比值作为诊断糖尿病(DM)的切点分别为5.86 mmol/L[曲线下面积(AUC)=0.922]、15.5%(AUC=1.00)、6.10%(AUC=1.00)及2.95(AUC=0.992),其敏感性为86.8%、100%、98.7%及93.4%,特异性均为100%,P值均<0.05;T2DM组中,FPG、GA及HbA1c作为诊断DM的切点分别为5.94 mmol/L(AUC=0.941)、15.5%(AUC=0.977)及5.95%(AUC=0.991),其敏感性为91.7%、85.7%及97.6%,特异性均为100%(P值均<0.05),GA/HbA1c比值无诊断切点(AUC=0.644,P值>0.05)。结论:FPG、GA、HbA1c及GA/HbA1c比值在T1DM和T2DM中具有极高的疗效观察、诊断及分型价值,应用各指标生物参考区间上限诊断T1DM和T2DM均存在漏检现象,T1DM患者密切关注FPG水平更为重要。

GA/HbA1c比值与2型糖尿病患者颈动脉粥样硬化斑块相关性

目的:评价GA/Hb A1c比值与2型糖尿病颈动脉粥样硬化斑块相关性。方法:选取四川省人民医院内分泌科住院的2型糖尿病患者,收集临床数据进行分析。结果:纳入154例患者,相关分析显示GA/Hb A1c比值与体质指数、血尿酸呈负相关;与年龄、同型半胱氨酸、空腹血糖、餐后血糖、左和右侧颈动脉中层厚度呈正相关。其中颈动脉斑块阳性组与阴性组相比,GA、GA/Hb A1c比值及同型半胱氨酸水平前者显著高于后者。Logistic回归分析显示GA/Hb A1c比值是影响2型糖尿病患者发生颈动脉粥样硬化斑块的独立危险因素(P=0.008)。结论:GA/Hb A1c比值与2型糖尿病患者颈动脉中层厚度呈正相关。这提示GA/Hb A1c比值能作为预测糖尿病患者心血管并发症的潜在临床指标。

2型糖尿病患者脂联素、GA/HbA1c比值与周围神经病变的相关性研究

目的探讨T2DM患者血清APN水平、糖化白蛋白(GA)和糖化血红蛋白(HbA1c)比值(GA/HbA1c)与糖尿病周围神经病变(DPN)的相关性。方法随机选取2021年7~12月住院的T2DM患者120例,根据患者临床资料及神经传导功能检查(NCS)分为T2DM不伴周围神经病变组(NDPN)和T2DM并发周围神经病变组(DPN)。比较2组一般资料及生化指标、脂联素(APN)水平、血糖控制指标,采用多因素logistic回归分析T2DM患者并发DPN的独立危险因素,受试者工作特征(ROC)曲线分析差异指标的预测价值。结果120例T2DM患者中检出NDPN组47例、DPN组73例。DPN组患者血清DM病程、DBP、BUN的水平均高于NDPN组,差异有统计学意义(P<0.05)。与NDPN组相比,DPN组APN、FPG、GA水平及GA/HbA1c比值均较高(P<0.05)。Logistic回归分析显示,APN、DM病程及GA/HbA1c是导致T2DM患者并发DPN的独立危险因素。ROC曲线分析显示,APN、DM病程、GA/HbA1c比值对DPN患病预测的曲线下面积(AUC)分别为0.893、0.715、0.808。结论血清APN水平降低和GA/HbA1c比值升高可能是预测T2DM并发DPN的良好指标。

GA/HbA1c比值与2型糖尿病周围神经病变相关性研究

目的研究2型糖尿病患者血GA/HbA1c比值与糖尿病周围神经病变的相关性。方法选取2018-12-2019-11在福建中医药大学附属人民医院住院的糖尿病患者681例。随机分为2型糖尿病不伴周围神经病变(NDPN)组366例,2型糖尿病周围神经病变(DPN)组315例。结果NDPN组与DPN组年龄、病程、BMI、HbA1c、GA、GA/HbA1c、TG比较差异有统计学意义(P<0.05)。DPN组患者合并心血管病、糖尿病肾病及糖尿病视网膜病变的比例明显高于NDPN组,差异有统计学意义(P<0.05)。Logistic回归分析显示,病程、GA/HbA1c、合并糖尿病肾病及糖尿病视网膜病变是DPN独立危险因素。ROC曲线显示,HbA1c曲线下面积(AUC)为0.601,Cut-off值为8.05%(敏感性65.2%,特异性51.8%);GA曲线下面积(AUC)为0.706,Cut-off值为24%(敏感性70.6%,特异性62%);GA/HbA1c曲线下面积(AUC)为0.763,Cut-off值为2.82(敏感性81.6%,特异性65.1%)。结论GA/HbA1c可能是预测糖尿病周围神经病变良好指标。

FPG、GA、HbA1c及OGTT-2hPG联合检测在2型糖尿病患者持续跟踪监测中的应用评价分析

目的FPG、GA、HbA1c及OGTT-2hPG联合检测在2型糖尿病患者持续跟踪监测中的应用评价分析。方法对2016年12月-2017年2月间在我院就诊的374例患者中,已确诊为2型糖尿病的125例患者进行第二次的跟踪随访及疗效监测,检测相应的FPG、GA、HbA1c、OGTT-2hPG等参数。结果①在随访的125例糖尿病患者中,接受糖尿病药物治疗的占76.8%,较第一次随访增加2.4%。拒绝接受糖尿病药物治疗占19.2%,较第一次随访减少3.2%。其中有4例在医生的指导下使用药物治疗效果明显。②进行糖尿病药物治疗的患者(A组)治疗前与第二次随访比较,FPG、GA、HbA1c及OGTT-2hPG差异均具有统计学意义(P<0.05);第一次随访与第二次随访比较,FPG、GA及OGTT-2hPG差异均具有统计学意义(P<0.05)。③单一药物组(A1组)治疗前与第二次随访比较,FPG及GA差异具有统计学意义(P<0.05);第一次随访与第二次随访比较,FPG、HbA1c、GA及OGTT-2hPG差异均不具有统计学意义(P>0.05)。④联合用药组(A2组)治疗前与第二次随访比较,FPG、GA及OGTT-2hPG差异均具有统计学意义(P<0.05);第一次随访与第二次随访比较,GA及OGTT-2hPG差异均具有统计学意义(P<0.05)。⑤拒绝接受糖尿病药物治疗的患者(B组)三次监测比较,FPG、GA、HbA1c及OGTT-2hPG,差异均不具有统计学意(P>0.05)。结论FPG、GA、HbA1c及OGTT-2hPG联合检测在2型糖尿病患者持续跟踪监测和治疗中具有一定临床指导价值。

The Correlation among TIR, HbA1c,1, 5-AG and GA in Patients with 3rd Stage of Diabetic Nephropathy

Objective:To investigate the correlation among time in range(TIR),hemoglobinA1c(HbA1c),1,5-anhydroglucitol(1,5-AG)and glycated albumin(GA)in patients with 3rd stage of diabetic nephropathy.Methods:HbA1c,1,5-AG and GA were detected in120 patients with 3rd stage of diabetic nephropathy and flash glucose monitoring(FGM)was used to observe patients'TIR.The general characteristics,laboratory data and FGM blood glucose data of the groups≥70%and<70%of TIR3.9-10.0 were observed,and the correlation among TIR3.9-10.0,HbA1c,1,5-ag and GA was summarized.Results:There was no significant difference in general information and laboratory data in addition to glycemic monitoring indicators between the two groups of TIR3.9-10.0≥70%and TIR3.9-10.0<70%(P>0.05).After adjusting hemoglobin(HGB),TIR3.9-10.0 was negatively correlated with HbA1c,r=-0.871;after adjusting estimated glomerular filtration rate(eGFR),TIR3.9-10.0 was positively correlated with 1,5-AG concentration,r=0.591;after adjusting serum albumin(ALB),TIR3.9-10.0 was negatively correlated with GA concentration,r=-0.521;all P values were less than 0.05.Conclusion:TIR3.9-10.0 correlated with 1,5-AG and GA in patients with 3rd stage of diabetic nephropathy,which can be considered as an evaluation index of short-term glycemic control in patients with early diabetic nephropathy.

Role of lymphocyte-to-monocyte ratio as a predictive marker for diabetic coronary artery disease: A cross-sectional study

BACKGROUND The lymphocyte to monocyte ratio(LMR)is considered a marker of systemic inflammation in cardiovascular disease and acts as predictor of mortality in coronary artery disease.AIM To investigate the predictive role of LMR in diabetic coronary artery disease patients.METHODS This cross-sectional study was conducted at tertiary care super-specialty hospital at New Delhi,India.A total of 200 angiography-proven coronary artery disease(CAD)patients were enrolled and grouped into two categories:Group I[CAD patients with type 2 diabetes mellitus(T2DM)and glycated hemoglobin(HbA1c)levels≥6.5%],and Group II(CAD patients without T2DM and HbA1c levels<6.5%).Serum lipoproteins,HbA1c,and complete blood count of enrolled patients were analyzed using fully automatic analyzers.RESULTS The logistic regression analysis showed an odds ratio of 1.48(95%CI:1.28-1.72,P<0.05)for diabetic coronary artery disease patients(Group I)in unadjusted model.After adjusting for age,gender,diet,smoking,and hypertension history,the odds ratio increased to 1.49(95%CI:1.29-1.74,P<0.01)in close association with LMR.Further adjustment for high cholesterol and triglycerides yielded the same odds ratio of 1.49(95%CI:1.27-1.75,P<0.01).Receiver operating characteristic curve analysis revealed 74%sensitivity,64%specificity,and 0.74 area under the curve(95%CI:0.67-0.80,P<0.001),suggesting moderate predictive accuracy for diabetic CAD patients.CONCLUSION LMR showed positive association with diabetic coronary artery disease,with moderate predictive accuracy.These findings have implications for improving CAD management in diabetics,necessitating further research and targeted interventions.

Status of Micro and Macro Nutrients in Patients with Type 2 Diabetes Mellitus Suggesting the Importance of Cation Ratios

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic polymetabolic disorder characterized by chronic hyperglycemia resulting from resistance to insulin action or inadequacy of insulin secretion. Role of the micro & macro nutrients in the pathogenesis of T2DM has not been studied thoroughly. The aim of this study was to evaluate the status of calcium, magnesium, zinc and chromium in relation to HbA1c in a group of subjects with T2DM patients. Methodology: The study comprised of seventy three patients with T2DM, attending the OP of a tertiary care medical college hospital. Thirty four individuals were with HbA1c < 7% (group 1) and thirty nine with HbA1c ≥ 7% (group 2). Cation concentrations were determined using Atomic Absorption Spectroscopy and HbA1c by ion exchange chromatography. Results: The individual cation concentrations were not significantly different between the groups. Association of these serum ion concentrations with the glycemic control in group 2 (HbA1c 7%) was noted. Significant association of cation ratios with glycemic control was noted. Conclusion: The concentration of magnesium, zinc and chromium were low in subjects with poor glycemic control (HbA1c > 7%). Cation ratios were significantly associated with the glycemic control in T2DM.

GA/HbA1c比值测定在早期诊断糖尿病肾病中的临床价值

目的探讨GA/HbA1c比值测定在早期糖尿病肾病患者诊断中的价值。方法随机抽取2014年10月至2017年3月在该院老年科、内分泌科及肾内科住院确诊的68例2型糖尿病(T2DM)患者,按患者24小时尿蛋白定量(24 h pro)水平分为正常蛋白尿(NAU)组及糖尿病肾病(DN)组,DN组患者再分为微量蛋白尿(MAU)亚组和临床蛋白尿(CAU)亚组;另选42例健康体检者为对照组(NC组)。所有受检者均检测血清尿素氮(BUN)、肌酐(Cr)、糖化血清蛋白(GA)、糖化血红蛋白(HbA1c)及24 h pro等各项生化指标,计算GA/HbA1c比值。结果与NC组相比,NUA组、DN组GA、HbA1c、24 h pro水平及GA/HbA1c比值均显著升高(P<0.05)。在T2DM患者中,GA/HbA1c比值与24 h pro呈正相关,但在CAU组中的相关性偏低。结论 GA/HbA1c比值有望作为早期检测糖尿病肾病的潜在临床指标,但对晚期肾损害不敏感。

2型糖尿病患者糖化白蛋白/糖化血红蛋白比值与动态血糖参数的相关性分析

目的探讨2型糖尿病(T2DM)患者糖化白蛋白(GA)/糖化血红蛋白(HbA1c)比值与动态血糖监测(CGM)参数间的相关性。方法选择2020年1月至2021年12月首次就诊于复旦大学附属中山医院内分泌科的100例T2DM患者,以GA/HbA1c比值三分位数分组。患者入院后佩戴扫描式血糖监测仪,记录其入院后第3~5天的72 h血糖结果,计算平均血糖、平均血糖波动幅度(MAGE)、最高与最低血糖差(ΔBG),以及血糖在目标范围内时间(TIR)、血糖高于目标范围时间(TAR)、血糖低于目标范围时间(TBR)。分析GA/HbA1c比值与动态血糖参数的相关性。结果随着GA/HbA1c比值升高,MAGE、空腹血糖(FBG)、ΔBG升高,精氨酸激发后C肽峰值降低(P<0.05)。Pearson相关分析或Spearman秩相关分析显示,GA/HbA1c比值与空腹C肽、精氨酸激发后C肽和TIR负相关(P<0.01),与FBG、ΔBG、MAGE正相关(P<0.05),与并发症数量无相关性。多元线性回归分析显示,GA/HbA1c比值与MAGE、ΔBG、TIR独立相关(P<0.05)。Logistic回归分析显示,GA/HbA1c比值升高是TIR<70%的独立危险因素(OR=6.990,95%CI 2.179~22.423,P<0.01)。结论GA/HbA1c比值与T2DM患者的残余胰岛β细胞功能相关,与血糖波动参数MAGE、ΔBG、TIR独立相关,可作为评估胰岛功能、监测血糖波动的敏感指标。

血清糖化白蛋白、糖化血红蛋白、空腹血糖对妊娠期糖尿病孕妇的筛选价值分析

目的探究血清糖化白蛋白(GA)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)对妊娠期糖尿病(gesta⁃tional diabetes mellitus,GDM)的筛选价值。方法将2021年2月—2022年2月山东莘县人民医院收治的91例符合诊断标准的GDM患者纳入研究组,将同期行常规产检的91名健康孕妇作为参比组。先对所有研究对象进行口服葡萄糖耐量实验,然后进行血清糖化白蛋白、糖化血红蛋白、空腹血糖检测。对比检测结果差异,分析研究组HbA1c、GA以及FPG检测指标的准确率。结果研究组1 h葡萄糖耐量、2 h葡萄糖耐量、HbA1c、FPG及GA水平均高于参照组,差异有统计学意义(P<0.05)。HbA1c、GA、FPG检测的准确率分别为90.11%、93.41%、82.42%,差异无统计学意义(P>0.05)。GA检测的准确率略高于HbA1c,但差异无统计学意义(χ^(2)=0.654,P=0.419);HbA1c检测的准确率略高于FPG,但差异无统计学意义(χ^(2)=2.272,P=0.132);GA检测的准确率与FPG相比,差异有统计学意义(χ^(2)=5.171,P=0.023)。结论HbA1c、GA和FPG 3种指标均对妊娠期糖尿病具有一定的筛选价值,其中GA检测效果高于FPG,GA与HbA1c效果相当。

1,5-脱水葡萄糖醇、糖化白蛋白及糖化白蛋白/糖化血红蛋白比值应用于暴发性1型糖尿病早期诊断的价值

目的探讨血1,5-脱水葡萄糖醇(1,5-AG)、糖化白蛋白(GA)和GA/糖化血红蛋白(HbA1c)比值用于暴发性1型糖尿病(FT1DM)和经典1型糖尿病(T1ADM)早期鉴别诊断的价值。方法收集2007年1月至2018年7月上海交通大学附属第六人民医院20例FT1DM患者及47例HbA1c<8.7%且年龄和性别匹配的新诊断T1ADM患者。测定其1,5-AG、GA、HbA1c等相关指标。采用t检验、Mann-Whitney U检验比较FT1DM和T1ADM患者的1,5-AG、GA及GA/HbA1c比值,采用受试者工作特性(ROC)曲线评价不同血糖监测指标鉴别FT1DM和HbA1c<8.7%的T1ADM的效能。结果FT1DM患者的血清1,5-AG水平低于T1ADM,FT1DM患者的血清GA水平较T1ADM稍有增加,但差异均无统计学意义(均P>0.05)。FT1DM患者的GA/HbA1c水平较T1ADM患者升高,差异有统计学意义(P=0.001)。1,5-AG和GA鉴别两者的最佳切点分别为6.2μg/ml和17.9%,其灵敏度分别为95.0%和90.0%,但特异度仅为31.9%和34.0%,曲线下面积(AUC)为0.597和0.601,两者筛查效力差异无统计学意义(P=0.972)。而对于GA/HbA1c比值,其最佳切点为>3.187,灵敏度为70.0%,特异度为76.6%,AUC为0.769,优于单用1,5-AG或GA。结论GA/HbA1c比值在早期识别FT1DM方面,优于单用1,5-AG或GA。

糖化血红蛋白和糖化血清白蛋白联合检测在糖尿病中的筛查价值

目的:探讨糖化血红蛋白和糖化血清白蛋白联合检测在糖尿病中的筛查价值。方法:选取我院2012年3月至2013年7月842例进行糖尿病筛查的个体作为研究对象,通过检测研究对象HbA1c(糖化血红蛋白)、GA(糖化血清白蛋白)水平,分析HbA1c、GA和糖尿病的关系。结果:参加研究的受检者BMI为(24.32±3.61)kg/m2,收缩压为(128.11±18.25)mm Hg,舒张压为(82.41±11.07)mm Hg,空腹血糖(6.05±1.59)mmol/L,餐后2小时血糖(9.97±4.32)mmol/L,糖化血红蛋白(6.17±1.13)%,糖化血清白蛋白(17.82±4.53)%。NGT组、IGR组和DM组三组HbA1c、GA比较不全相等(P<0.05),且各组间两两比较也存在差异,差异均具有统计学意义(P<0.05);Pearson积差相关分析显示,研究对象HbA1c、GA、FPG(空腹血糖)、2 hPG(餐后2小时血糖)这四个指标两两之间均呈正相关(P<0.05)。结论:HbA1c和GA联合检测在糖尿病筛查中有应用价值,值得在实际工作中应用推广。