[WCIR2009]糖尿病诊断进展与个体化治疗--Z.Bloomgarden教授访谈:
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专家访谈 临床科研 作者:ZacharyT.Bloomgarden 来源:未知 2009/12/1 9:47:00    加入收藏
内容概要:《国际糖尿病》:糖化血红蛋白(HbA1c)或联合空腹血糖(FPG)被建议用作糖尿病的诊断标准已有很长的时间了,这些建议是否已被广泛采纳,还是仍需进一步研究验证?

 中文内容已更新 2009-12-01

   International Diabetes:  It has long been argued that glycosylated hemoglobin (HbA1c) along or in combination with fasting plasma glucose (FPG) might be used as the criterion for diabetes diagnosis. Now we are wondering if this proposal has been widely accepted or if further research is required?

《国际糖尿病》:糖化血红蛋白(HbA1c)或联合空腹血糖(FPG)被建议用作糖尿病的诊断标准已有很长的时间了,这些建议是否已被广泛采纳,还是仍需进一步研究验证? 

    Dr Bloomgarden: I am very aware of this concept of using A1c for diagnosis of diabetes and it is no question that A1c increases with increasing blood sugar in a given person but there are some very interesting and disturbing data that suggest that the relationship between the A1c and blood sugar varies from one person to another so that a person who is older seems to have a higher A1c for given blood sugar than a person who is younger.  A person who is anemic has a lower A1c at a given blood sugar level.  There is variation with ethnicity so that within the United States,African Americans,blacks seem to have a considerably higher A1c than Whites and Hispanics.  Asians appear to be somewhere in the middle.  There is variation with a variety of genetic factors that we are just beginning to work out so if we use a certain diagnostic level and say A1c of 6.5 is diabetes,A1c of 6.4 is not diabetes we may really not be fully taking into account the many factors that change the amount of glucose that is attached to that protein hemoglobin in red blood cells. 

Bloomgarden教授:我十分清楚利用A1c诊断糖尿病的观念, 在既定个体内A1c会随着血糖的升高而增加这是毫无疑问,但是有一些非常有趣但却扰人的数据提示A1c和血糖的关系因人而异,对于具有同一血糖水平的人来说,年长者的A1c较高,而贫血的患者较不贫血的患者的A1c为低。它也存在种族差异,在美国,美国人、非洲人、黑人与白人和西班牙人比较,前三者具有相当高的A1c水平。亚洲人A1c居中。我们也刚刚开始发现,它也会随着遗传因素不同而改变。因此说如果我们将A1c某一特定数值作为诊断的标准,例如说A1c 6.5诊断为糖尿病,而6.4不是糖尿病,这样做确实没有全面考虑影响红细胞内血红蛋白与葡萄糖相结合的各种影响因素。
 



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非常赞同Bloomgarden教授的观点

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