血红蛋白糖化指数对糖尿病前期和糖尿病的诊断意义。,The Journal of Clinical Endocrinology & Metabolism - X-MOL

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血红蛋白糖化指数对糖尿病前期和糖尿病的诊断意义。
The Journal of Clinical Endocrinology & Metabolism ( IF 5.0 ) Pub Date : 2020-03-01 , DOI: 10.1210/clinem/dgaa029
Daniel S Hsia ₁ , Neda Rasouli ₂ , Anastassios G Pittas ₃ , Christine W Lary ₄ , Anne Peters ₅ , Michael R Lewis ₆ , Sangeeta R Kashyap ₇ , Karen C Johnson ₈ , Erin S LeBlanc ₉ , Lawrence S Phillips ₁₀ , James M Hempe ₁₁ , Cyrus V Desouza ₁₂ ,

Affiliation

Pennington Biomedical Research Center, Baton Rouge, Louisiana.
University of Colorado, School of Medicine and VA Eastern Colorado Health Care System, Aurora, Colorado.
Tufts Medical Center, Boston, Massachusetts.
Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, Maine.
Keck School of Medicine of the University of Southern California, Los Angeles, California.
Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, Vermont.
Cleveland Clinic, Cleveland, Ohio.
University of Tennessee Health Science Center, Memphis, Tennessee.
Kaiser Permanente Center for Health Research NW, Portland, Oregon.
Atlanta VA Medical Center, Decatur, Georgia and Emory University School of Medicine, Atlanta, Georgia.
Louisiana State University Health Sciences Center, New Orleans, Louisiana.
Omaha VA Medical Center, University of Nebraska Medical Center, Omaha, Nebraska.

目的空腹血糖（FPG），75克口服葡萄糖耐量试验（OGTT）的2小时血浆葡萄糖（2hPG）和糖化血红蛋白（HbA1c）在诊断糖尿病前期和糖尿病时可能导致不同的结果。血红蛋白糖化指数（HGI）量化了糖基化的个体差异，从而导致FPG和HbA1c之间存在差异。我们使用了来自维生素D和2型糖尿病（D2d）研究的数据来计算HGI，识别HGI相关变量以及确定HGI如何影响糖尿病前期和糖尿病诊断。测量采用筛查队列（n = 6829）得出线性回归方程[HbA1c（％）= 0.0164×FPG（mg / dL）+ 4.2]，并用于计算预测的HbA1c。从观察到的HbA1c中减去该值，以2hPG数据（n = 3945）确定基线队列中的HGI。比较低，中和高HGI亚组的基线变量加上前驱糖尿病和通过FPG，HbA1c和2hPG进行的糖尿病诊断。结果妇女和美国黑人/非裔美国人的比例从低HGI子群增加到高HGI子群。从低HGI到高HGI亚组，平均FPG降低，平均HbA1c增加，与HGI计算一致；然而，平均2hPG在HGI亚组之间没有显着差异。结论如前所述，高HGI与黑人种族和女性有关。在HGI亚组中2hPG没有差异的观察表明，餐后血糖的变化并不是HGI人群变化的重要来源。与使用FPG或2hPG相比，仅使用HbA1c诊断可将更多黑人个体和女性归为患有糖尿病前期。

"点击查看英文标题和摘要"

Implications of the Hemoglobin Glycation Index on the Diagnosis of Prediabetes and Diabetes.

OBJECTIVE Fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG) from a 75-g oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) can lead to different results when diagnosing prediabetes and diabetes. The Hemoglobin Glycation Index (HGI) quantifies the interindividual variation in glycation resulting in discrepancies between FPG and HbA1c. We used data from the Vitamin D and Type 2 Diabetes (D2d) study to calculate HGI, to identify HGI-associated variables, and to determine how HGI affects prediabetes and diabetes diagnosis. MEASUREMENTS A linear regression equation [HbA1c (%) = 0.0164 × FPG (mg/dL) + 4.2] was derived using the screening cohort (n = 6829) and applied to calculate predicted HbA1c. This was subtracted from the observed HbA1c to determine HGI in the baseline cohort with 2hPG data (n = 3945). Baseline variables plus prediabetes and diabetes diagnosis by FPG, HbA1c, and 2hPG were compared among low, moderate, and high HGI subgroups. RESULTS The proportion of women and Black/African American individuals increased from low to high HGI subgroups. Mean FPG decreased and mean HbA1c increased from low to high HGI subgroups, consistent with the HGI calculation; however, mean 2hPG was not significantly different among HGI subgroups. CONCLUSIONS High HGI was associated with Black race and female sex as reported previously. The observation that 2hPG was not different across HGI subgroups suggests that variation in postprandial glucose is not a significant source of population variation in HGI. Exclusive use of HbA1c for diagnosis will classify more Black individuals and women as having prediabetes compared with using FPG or 2hPG.

更新日期：2020-01-22

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