·HbA1c的临床应用·

　　【摘要】 目的 探讨HbA1c与胰岛β细胞功能间的相关性。 方法 对251例研究对象进行75 g OGTT，测定不同时段血糖、血清胰岛素、C-P水平，并测定HbA1c及临床生化指标，对所得数据进行统计分析，绘制ROC曲线寻找最佳界值，并分组比较。 结果 本研究中，HbA1c诊断T2DM的最佳界值为7.05%。与HbA1c≥7.05%组0.5 h[(1.93±1.11) vs (1.23±0.78)，P=0.019]、1 hC-P[(2.7±1.08) vs (1.65±1.11)，P=0.001]，0.5 h[(292.96±96.56) vs (1154.42±88.06)， P=0.035]、1 h[(372.73±265.78) vs (166.80±131.02)，P=0.005]、2 hIns[(327.67±232.9) vs (191.27±193.7)，P=0.015]及胰岛细胞功能指数[HOMA-β,(1159.12±283.95) vs(994.51±281.21)， P=0.025]均低于HbA1c<7.05%组;HbA1c与各时间段C-P呈负相关(r=-0.250，P=0.001;r=-0.502、-0.626、-0.611、-5.070，P=0.000)，与各时段胰岛素呈负相关(r=-0.239、-0.532、-0.682、-0.617、-0.504，P=0.000)，与HOMA-β和ISI呈负相关(r=-0.665、-0.554，P=0.000)。 结论 HbA1c可作为新疆地区T2DM筛查及诊断的指标，还可用来初步判断胰岛β细胞功能的状态。

　　【关键词】 糖尿病，2型;糖化血红蛋白;胰岛β细胞功能

　　【Abstract】 Objective To investigate the correlation between the HbA1c and beta-cell function. Methods A total of 251 participants underwent 75 g oral glucose tolerance test(OGTT). The plasma glucose, insulin levels and C-peptide at different time points and HbA1c were measured. The clinical and biochemical makers were also tested. The statistical analysis and ROC curve were performed using SPSS version 17.0. Results The best cut-off point for HbA1c to diagnose T2DM was 7.05%. All subjects were divided into two groups: HbA1c<7.05% and HbA1c≥7.05% group. Compared with the HbA1c<7.05% group, the C-P at 0.5 h[(1.93±1.11)vs(1.23±0.78)，P=0.019] and 1 h [(2.7±1.08)vs(1.65±1.11)，P=0.001],Insulin levels at 0.5h[(292.96±96.56)vs(1154.42±88.06)，P=0.035],1h[(372.73±265.78)vs(166.80±131.02)，P=0.005],2h[(327.67±232.9)vs(191.27±193.7)，P=0.015],and the HOMA-β level [(1075.12±2923.98)vs(319.78±871.15)，P=0.025] of HbA1c≥7.05% group were lower. There was negative correlation between HbA1c and C-P of different time points (r=-0.25, P=0.001; r=-0.502, -0.626, -0.611, -0.507, P=0.000). There was negative correlation between HbA1c and Insulin at different time points (r=-0.239, -0.532, -0.682, -0.617, -0.504, P=0.000).The negative correlation could also be seen between HbA1c and HOMA-β, IS (r=-0.665,-0.554, P=0.000). Conclusion HbA1c could be used as screening and diagnosing standard for T2DM in Xinjiang, and also can be used in evaluating islet beta-cell function.

　　【Key words】 Diabetes mellitus，type 2; Hemoglobin(HbA1c); Islet β cell function