糖化血红蛋白的研究进展.doc

20081035lO(HbA1C)HbA1 CHbA1c R4461 12 A 10042369(2008)10-0586-03The progress in researches on glycosylated hemoglobin Alc XUE ShengnengCHENG HuaDepartmentof EndocrinologyThe Second Afiliated HospitalSun YatSen UniversityGuangzhou 510120ChinaAbstractGlycosylated hemoglobin(GHb)used as a gold standard reflecting long term level of blood glucoseis an important index to monitor the blood glucose level of patients with diabetes mellitusThe standardizationof hemoglobin A1 e(HbA1 C)has attracted more and more peopleg attention in recent yearsThe basic conceptmajor detection methodsinterference factorsclinical applicationespecially the standardization of HbA1 ewere reviewed in this articleKey wordsGlycosylated hemoglobin Diabetes mellitusStandardization(Int J Intern Med200835586588)(DM)DMDM(FBG)(PBG)(0GrITr)(GHb)DM(Hb)A1cGHb1. HbAlcGHbHbGHb120 dGHb120 dHbA1cGHbGHbJHbAHb901958AllenHbA3HbAHbA1aHbAlbHbA1cDM1975HbA1cHbAHbA1cFBG1980HbA112DMDM2. HbAlcHbA1cHbA1cHbA1cGHb(CV)3HbHbHbHbA1CCV3 20 (IFCC)HbA1 cHbA1CHbA N6HbA1c3. HbAlcHbA1c6(G6PD)14HbA1cG6PDDMHbA1eDMcEHbHbA1cHbHbHbA1CBry HbA1C(httpwwwngsporg)CV4(3)(NCCLS)DMCVHbA1e HbA1CHbA1C(HbA1c)HbA1e?HbA1e?HbA1C 10 mmolLHbA1CHbA1CHbA1cHbA1cHbA1e120 dHbA1cHbA1CHbA1c3050 d12(34)HbA1cHbA1C30 dHbA1C50 90120 d10 ? 4. HbAlc41 DMHbA1CDM2002DM(ADA)DMADAHbA1eDM HbA1cDM JADADMHbA1c24DCCT141HbA1c5 3DM(GDM)3HbA1CGDMHbA1cGDM JKennedy HbA1CDM(DCCT)DM(UKPDS)HbA1eDM TanakaDM6 9HbA1e1(7)DMDM1 2 2HbA1cDMDMHbA1C42 DMHbA1cDMDM HbA1cFBGHbA1cDCCTHbA1c95 mmolLHbA1c1 YoshihikHbA1cFBG109DMHbA1c18FBGDMHbA1cOGTrDMHbA1eOGTf JHbA1c61FBG70 mmoL2 h111 mmolLElDMHbA1c65DM ?43 DMHbA1cDMHbA1cHbA1c5. HbAlcHbA1cDMHbA1cHbA1 cHbA1c301990HbA1c1996GHb(NGSP)DCCTHbA1 cNGSPDCCT(NGSP)NGSPHbA1cNGsPHbA1cGHbHbA1cDCCT199699 HbA1c98NGSP NGSPGHbHbAleIFCCHbA1cIFCCHbA1c 13N6NGSPNGSPHbA1c(15 19)IFCCHbA1c(retooltoo1) IFCC-HbAIeNGSPHbA1c(Master equation)NGSPHbA1c( )=0915 X IFCCHbAlc()+215NGSPHbA1c()009 IFCCHbA1e(mmolmo1)+215NGSPHbA1cNGSP-HbAIc533mmomolNGSPHbA1c6548 mmotoolNGSP HbA1c865 retooltoolIFCCHbA1c 200754ADADM(EASD)IFCCDM(IDF)HbA1c14HbA1c IFCCHbA1cHbAlcIFCC(mmolmo1)IFCCNGSPNGSP()HbA1eNGSP()IFCCNGSPIFCC(mmomo1)()HbA1 c(A1c derived average g!ucoseADAG)HbA1cIFCCNGSPADAG2007943EASDDavid NathanADAG3001DM3O02DM1004(3 d7)48 h(CGMS)HbA1e42 700CGMS2 400HbA1c5427(2241DM1252DM78)HbA1c(eAG)eAG=2489HbA1c-4536HbA1cHbA1c?HbA1c?HbA1 c?6. HbA1cDMDM1. Goldstein DELittle RRLorenz RAet a1Tests of glycemia in diabetesDiabetes Care200427(7)1761-17732. Schnedl WJKrause RHalwachsBaumann Get a1Evaluation of HbA1 c determination methods in patients with hemo obinopathiesDiabetes Care200023(3)3393443. Bry LChen PCSacks DBEfects of hemoglobin variantsand chemically modified derivatives on assays for glycohemoglobinClin Chem200147(2)1531634. American Diabetes Association Clinical Practice Recommendations 2001Diabetes Care200124(Suppl 1)S1S1335. American Diabetes AssociationStandards of medical care indiabetesDiabetes Care200427(Suppl 1)S15$356. Evers IMde Valk HW Mol BW et a1Macrosomia despite good glycaemic control in Type I diabetic pregnancyresults of a nation wide study in The NetherlandsDiabetologia200245(11)148414897. Kennedy DMJohnson ABHill PGA comparison of automated fructosamine and HbA1 c methods for monitoring diabetes in pregnancyAnn Clin Biochem199835(Pt 2)2832898. Adler AIStratton IMNeil HAet a1Association of systolic blood pressure with macrovascular and microvascularcomplications of type 2 diabetes(UKPDS 36)prospectiveobservational studyBMJ2000321(7258)412_4199. Krishnamurti USteffes MW GIycohemoglobina primarypredictor of the development or reversal of complications ofdiabetes mellitusClin Chem200147(7)1 1571 16510. Tominaga MDiabetes mellitus and HbA1 cRinsho Byori200351(6)5865911. 1 Manley S Haemoglobin Al ca marker for complications oftype 2 diabetesthe experience from the UK Prospective DiabetesStudy(UKPDS)Clin Chem Lab Med200341(9)l182119012 International Federation of Clinical Chemistry and LaboratoryMedicineIFCC Scientific DivisionNordin Get a1Recommendation for term and measurement unit forHbAlcClin Chem Lab Med200745(8)1081108213 Hoelzel W Weykamp CJeppsson JOet a1 IFCC reference system for measurement of hemoglobin Al c in humanblood and the national standardization schemes in the UnitedStates Japan and Swedena methodcomparison studyClin Chem200450(1)16617414 American Diabetes AssociationE