·HbA1c的应用

　　王娈 马瑞欣 綦玉琴

　　作者单位：266003青岛大学医学院附属医院内分泌科

　　【摘要】 目的 分析HbA1c在糖耐量正常(NGT)人群中的分布特点及相关因素。 方法 对健康体检和糖尿病筛查者进行75g OGTT试验，同时检测HbA1c、血尿常规、FPG、2hPG及血生化，所有参加者进行人体学测量。将174名NGT人群的结果纳入分析，比较HbA1c在不同性别及年龄组间的差异，用线性回归方法分析HbA1c与年龄、FPG和2hPG的相关性;根据HbA1c结果分为≤5.6%和5.7%～6.4%两组，比较两组的临床特点。 结果  NGT人群的HbA1c呈正态分布，结果是(5.62±0.38)%，95%CI为4.88%~6.36%;不同性别间HbA1c无统计学差异;青年组(16~44岁)的HbA1c及FPG分别与中年组(45~59岁)和老年组(60~79岁)间均有统计学差异(P<0.01)，而2hPG无统计学差异; HbA1c≤5.6%和5.7%～6.4%组的年龄、血TG水平、FPG和2hPG均有统计学差异(P<0.01或P<0.05)。 结论 应建立本实验室HbA1c的正常参考值范围;NGT人群的HbA1c随年龄的增长而升高，并与FPG呈正相关;处于高危HbA1c范围的非糖尿病人群应加强对FPG、2hPG和TG的监测。

　　【关键词】糖化血红蛋白;参考范围;年龄;空腹血浆葡萄糖;甘油三酯

　　doi:10.3969/j.issn.1006-6187.2011.11.004

　　The analysis of glycated hemoglobin (HbA1c) values in 174 normal glucose tolerance population WANG Luan, MA Rui-xin，QI Yu-qin. Endocrinology Department, The Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, China

　　【Abstract】 Objective   To analyze the results of glycated hemoglobin measurement and related factors in normal glucose tolerance population.   Methods   A 75 g oral glucose tolerance test (OGTT) was administered to health check-up subjects and diabetes screening population. HbA1c detecting, regular hemotology test, urine test, fasting plasma glucose (FPG), 2 hours plasma glucose (2hPG) and blood biochemical test were conducted. Anthropometric measurements were performed to all the subjects. A total of 174 individuals with normal FPG and 2hPG were included for data analysis. Linear regression method was used to analyze the correlation of HbA1c to age ,FPG and 2hPG, respectively. Reference range of HbA1c was determined by 95% confidence interval for the mean HbA1c. All the subjects were divided into two groups: HbA1c ≤5.6% group and ≥5.7～6.4% group, and the clinical characteristics were compared between the two groups.   Results   HbA1c was normally distributed in our study population. The mean of HbA1c was 5.62% (SD 0.38%). The reference range was 4.88%~6.36%. There was no difference in HbA1c between male and female subjects (P>0.05). While a significant difference in HbA1c and FPG was found between age groups. Age, FPG ,2hPG and TG were statistically different (P<0.01 or P<0.05) between HbA1c≤5.6% and ≥5.7%～6.4% groups.   Conclusions   Each laboratory should make its own reference range of HbA1c test. HbA1c is positively correlated with age and FPG in the population with normal glucose tolerance. The non-diabetic population with high risk HbA1c value should monitor FPG ,2hPG and serum triglyceride more frequently.

　　【Key words】 Glycated hemoglobin;Reference range;Age;Fasting plasma glucose;