一种新的糖代谢监测指标——血清1,5-脱水山梨醇.docVIP

一种新的糖代谢监测指标——血清1,5-脱水山梨醇 一种新的糖代谢监测指标——血清1，5-脱水山梨醇 2010-01-13 方京冲　史虹莉　杨秀芳　沈稚舟　朱禧星 　　【摘要】　目的　评价1，5-脱水山梨醇(1，5-AG)作为一项新的指标在糖代谢监测中的临床意义。方法　对57例非糖尿病对照和110例2型糖尿病患者进行研究，对照组测定空腹血糖和1，5-AG。2型糖尿病患者测定空腹及餐后2小时血糖、糖基化血红蛋白(HbA1c)、果糖胺(FMN)、1，5-AG，尿白蛋白(Alb)、尿肌酐(Cr)，并计算尿白蛋白指数(Alb/Cr)。部分患者(45例)第二天行血糖监测，计算M值〔1〕。比较两组1，5-AG的差别。并分别按FBG、2hBG和HbA1c水平分组，比较各组间1，5-AG值。以1，5-AG为自变量，FBG、2hBG、ΔBG、HbA1c、FMN、M值和Alb/Cr为因变量行多元回归分析。结果糖尿病组1，5-AG水平明显低于非糖尿病对照组(6.41±6.16mg/L对27.96±7.75mg/L，P＜0.01)，且与HbA1c、FMN呈负相关(分别为r=-0.53,r=-0.41)。当血糖超过肾糖阈时，血中1，5-AG水平明显下降，且受肾脏病变程度的影响。与1，5-AG有关的因素为FBG、ΔBG、HbA1c、FMN、M值和Alb/Cr等，其中关系最为密切的因素为FMN和HbA1c。结论　由于1，5-AG仅反应高血糖状态，结合1，5-AG和HbA1c值可判断每天的血糖波动情况。因此，1，5-AG可为一种新的监测糖代谢指标。 　　【关键词】　1，5-脱水山梨醇　　糖尿病　　果糖胺　　血糖　　糖化血红蛋白　　尿白蛋白 Serum 1,5-anhydro-D-glucitol——a new clinical marker of glucose metabolism in type 2 diabetes mellitus Fang Jingchong,Shi Hongli,Yang Xiufang,et al.Diabetes Research Department, Huashan Hospital,Shanghai,200040 　　【Abstract】　Objective　To investigate the clinical significance of 1,5-anhydro-D-glucitol (1,5-AG) and its role as a new clinical marker in the evaluation for the glucose metabolism in type 2 diabetes mellitus patients. Methods　57 non-diabetic controls and 110 type 2 diabetes mellitus patients were enrolled into the study. Fasting blood glucose and 1,5-AG were measured. Additionally, postprandial serum glucose、HbA1c、Fructosamine (FMN)、urinary albumin and creatinine were tested in the type 2 diabetes mellitus group. Meanwhile, 45 patients received blood glucose monitoring and M level was calculated. All the diabetic patients were divided into 3 groups according to the FBG、2hBG and HbA1c levels respectively. Results　Serum level of 1,5-AG was obviously lower in the diabetics than that in the non-diabetic control (6.41±6.16mg/L vs 27.96±7.75 mg/L) and it was negatively correlated with HbA1candFMNlevels. As the blood glucose concentration exceeded the renal threshold, the serum concentration of 1,5-AG decreased markedly and was affected by distroyed renal fun