Is HbA1c affected by glycemic instability?

被引:102
作者
Derr, R [1 ]
Garrett, E [1 ]
Stacy, GA [1 ]
Saudek, CD [1 ]
机构
[1] Johns Hopkins Univ, Sch Med, Div Endocrinol & Metab, Dept Med, Baltimore, MD USA
关键词
D O I
10.2337/diacare.26.10.2728
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE- HbA(1c) is a standard clinical assessment of glycemia and the basis of most data relating glycemic control to complications. It remains' unclear, however, whether HbA(1c) is affected by glycemic variation and mean glycemia. RESEARCH DESIGN AND METHODS- To test this question, we analyzed the statistical relationship between. HbA(1c) levels. and glycemic variability as measured by self-monitoring of blood glucose (SMBG),. The records of 156 subjects were studied. SMBG data for the preceding 3 months. were downloaded, and HbA(1c) was measured by ion-exchange high-performance liquid chromatography. Simple- and random-effects linear regression models were used to assess the independent contributions of mean blood glucose (136) and SD of BG to HbA(1c), after adjusting for the mean BG. RESULTS- Mean +/- SD for HbA(1c) was 7.66 +/- 1.11% and for BG was 8.5 +/- 1.9 mmol/l (153.3 +/- 34.9 mg/dl); SD of BG for individual subjects was 3.5 mmol/l (63.3 mg/dl), varying from 0.4 mmol/l (8.1 mg/dl very stable glycemia) to 8.4 mmol/l (152.5 mg/dl; very unstable glycemia). A close correlation between mean BG and HbA, was demonstrated (r = 0.62). Also within-subject SD of BG correlated with HbA(1c) (r = 0.375), indicating that people with poorer glycemic control had higher BG variance. After adjusting for mean BG in a linear regression model, however, the effect of the within-subject SD of. BG on the HbA(1c) was insignificant. Several further analyses confirmed the strength of the observation. CONCLUSIONS- HbA(1c) reflects mean glycemia and is not meaningfully affected by glycemic instability after adjusting for mean BG.
引用
收藏
页码:2728 / 2733
页数:6
相关论文
共 18 条
  • [1] *AM DIAB ASS, 2002, DIABETES CARE, V24, P533
  • [2] [Anonymous], 1995, DIABETES, V44, P968
  • [4] *BIO RAD LAB, 1997, VAR HEM A1C PROGR
  • [5] GLYCOSYLATION OF HEMOGLOBIN - RELEVANCE TO DIABETES-MELLITUS
    BUNN, HF
    GABBAY, KH
    GALLOP, PM
    [J]. SCIENCE, 1978, 200 (4337) : 21 - 27
  • [6] BIOSYNTHESIS OF HUMAN HEMOGLOBIN A1C - SLOW GLYCOSYLATION OF HEMOGLOBIN INVIVO
    BUNN, HF
    HANEY, DN
    KAMIN, S
    GABBAY, KH
    GALLOP, PM
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1976, 57 (06) : 1652 - 1659
  • [7] *COLL STAT STAT CO, 2001, STAT STAT SOFTW RELE
  • [8] Revisiting the oral glucose tolerance test criterion for the diagnosis of diabetes
    Davidson, MB
    Schriger, DL
    Peters, AL
    Lorber, B
    [J]. JOURNAL OF GENERAL INTERNAL MEDICINE, 2000, 15 (08) : 551 - 555
  • [9] DWYER J, 1991, STAT MODELS LONGITUD, P3
  • [10] FLUCKIGER R, 1976, FEBS LETT, V71, P356, DOI 10.1016/0014-5793(76)80969-6