The correlation between blood glucose levels，blood glucose variability and glycated hemoglobin A1c levels in patients with type 2 diabetes
Fu Xuan1, Gao Hui1, A Mina1, Xiang Weiting1, Xie Aixia1, Tan Huiwen2, Li Nong1
1Department of Endocrinology and Metabolism, People's Hospital of Karamay, Karamay 834000, China; 2 Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
Abstract：ObjectiveTo investigate the relationship between blood glucose level, blood glucose variability and glycated hemoglobin A1c (HbA1c) in patients with type 2 diabetes. MethodsA total of 240 patients with type 2 diabetes who were admitted to the Endocrinology Department of People′s Hospital of Karamay from March 2019 to April 2020 were selected. Based on the HbA1c level, 240 patients were divided into 4 groups, Q1（5.5%-6.8%）（n=60）,Q2(6.9%-7.9%）（n=55）,Q3(8.0%-9.0%）（n=62） and Q4（9.1%-14.0%）（n=63）. The continuous blood glucose monitoring system (CGMS) was used for continuous 72h dynamic blood glucose monitoring.With HbA1c as the dependent variable, and parameters related to HbA1c as the independent variable, multiple linear regression method was used for regression analysis. ResultsThe fasting and 2h postprandial plasma glucose levels in the Q1-Q4 groups were 5.92(4.81，6.64)mmol/L and 10.27 (8.79，12.34)mmol/L, 6.37 (5.49，8.49)mmol/L and 12.02 (9.98,15.27)mmol/L, 8.45(6.78, 9.97)mmol/L and 14.45(11.51, 18.12)mmol/L, 10.16（8.09,11.52）mmol/L and 16.08(12.47,19.27)mmol/L, respectively. The mean values of dynamic blood glucose for 72h in the 4 groups were 7.41(6.71,8.14)mmol/L, 8.20(7.40, 9.30)mmol/L, 8.91(7.93, 10.35)mmol/L and 10.36(9.12, 11.79)mmol/L, respectively. The average fasting blood glucose and 2h postprandial glucose of the 4 groups increased with the increase of HbA1c, and the differences between the groups were statistically significant （H=81.35, 37.26,all P＜0.05）. Fasting and 2h postprandial blood glucose, the average value of 72h dynamic blood glucose,the time percentage of dynamic blood glucose ＞10.0mmol/L, the time percentage of dynamic blood glucose ＞7.8mmol/L and standard deviation of blood glucose levels (SDBG) were correlated with HbA1c (P＜0.05), and the correlation coefficients were 068, 0.46, 0.63, 0.59, 0.42 and 0.36, respectively. The multiple linear regression analysis results showed that the average values of 72h dynamic blood glucose and fasting glucose were HbA1c′s independent impact factors (B=0.23, 0.53, all P＜0.05). ConclusionsThe blood glucose variation has no effect on HbA1c. The levels of fasting blood glucose and mean blood glucose are the main affecting factors of HbA1c.
付煊 高晖 阿米娜 向蔚婷 谢爱霞 谭惠文 李农. 2型糖尿病患者血糖水平及血糖变异性与糖化血红蛋白水平的相关性研究[J]. 中华诊断学电子杂志, 2020, 8(4): 242-274.
Fu Xuan1, Gao Hui1, A Mina1, Xiang Weiting1, Xie Aixia1, Tan Huiwen2, Li Nong1. The correlation between blood glucose levels，blood glucose variability and glycated hemoglobin A1c levels in patients with type 2 diabetes. zhzdx, 2020, 8(4): 242-274.
