HbA1c 什么时候有用,这些数字意味着什么?

IF 0.4 Q4 ENDOCRINOLOGY & METABOLISM
S. Manley, Samiul Mostafa, Jonathan Webber, Kavitha D Ganapathy, Roy Taylor, Randie R Little, Rajeev P Raghavan, Craig Webster, Alison Barratt, R. Round, Irene Stratton, Andreas Karwath, John A. Williams, Georgios V. Gkoutos, G. Roberts, Sandip Ghosh
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引用次数: 0

摘要

背景:糖化血红蛋白(HbA1c)测量用于 2 型糖尿病(T2DM)的诊断、管理和缓解,其测量结果在全球范围内具有可比性,世界卫生组织列出了影响其准确性的医疗条件。有 5%的急诊入院患者的入院血糖在 "糖尿病 "范围内,而事先并未得到诊断,文献检索显示,使用 HbA1c 来确诊的做法并不一致。由于在 COVID-19 大流行期间无法进行口服葡萄糖耐量试验 (OGTT),皇家妇产科学院发布了使用 HbA1c 诊断妊娠糖尿病的指南。目的:本研究探讨了伯明翰伊丽莎白女王医院使用 HbA1c 的情况,该医院是一家大型大学医院,为多种族成人提供服务。方法:介绍可比性、临床审核、研究和当前实践方面的信息,并通过病例报告加以说明。结果:国家糖化血红蛋白标准化计划的数据显示,从 1993 年到 2023 年,实验室 HbA1c 和护理点检测方法具有可比性。尽管在 COVID-19 大流行期间,HbA1c 被用于诊断妊娠糖尿病,但大流行后医院已恢复使用 OGTT。相比之下,HbA1c 目前正被用于评估 T2DM 的缓解情况。病例报告说明了这些情况,并强调了当 HbA1c 读数的准确性受到多种并发症影响时决策的复杂性。结论:HbA1c 的广泛应用包括 T2DM 的缓解,但妊娠糖尿病的诊断在大流行后又恢复了 OGTT。本报告以图解的方式介绍了 HbA1c 的范围,以帮助人们了解这项检查。除了血红蛋白变异或红细胞周转异常者外,它适用于大多数人的糖尿病诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
When is HbA1c useful and what do the numbers mean – do they help or hinder?
Background: Glycated haemoglobin (HbA1c) measurement is used for diagnosis, management and remission of type 2 diabetes (T2DM), with measurements comparable worldwide and the World Health Organization listing medical conditions that affect its accuracy. Admission glucose is in the ‘diabetes’ range in 5% of emergency hospital admissions without prior diagnosis, with literature searches indicating inconsistent practice on using HbA1c to confirm diagnosis. As oral glucose tolerance tests (OGTT) were not possible during the COVID-19 pandemic, guidance was issued by the Royal College of Obstetrics and Gynaecology on using HbA1c for gestational diabetes mellitus. Aims: This study explores use of HbA1c at Queen Elizabeth Hospital Birmingham, a large university hospital serving a multi- ethnic adult population. Methods: Information is presented on comparability, clinical audits, research studies and current practice, and is illustrated by case reports. Results: Data from the National Glycohemoglobin Standardization Program show comparability of laboratoryHbA1c and point-of-care testing methods from 1993 to 2023. Although HbA1c was used to diagnose gestational diabetes during the COVID-19 pandemic, hospitals have reverted to OGTT post pandemic. In contrast, HbA1c is now being used to assess T2DM remission. Case reports illustrate these scenarios and highlight the complexity of decision-making when the accuracy of the HbA1c reading is affected by multiple co- morbidities. Conclusions: This wider use of HbA1c includes remission of T2DM but the diagnosis of gestational diabetes has reverted to OGTT post pandemic. A pictorial representation of HbA1c range is presented to aid understanding of this test. It is suitable for diagnosis of diabetes in most people except those with some variant haemoglobins or abnormal red blood cell turnover.
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来源期刊
British Journal of Diabetes
British Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
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16.70%
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15
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