南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (11): 1606-.

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血清1,5-脱水葡萄糖醇可反映暴发性1型糖尿病患者的血糖急性变化

葛金莲,徐大成,彭友帆,张明琛,曹文艳   

  • 出版日期:2015-11-20 发布日期:2015-11-20

Serum 1, 5-anhydroglucose alcohol: a serum indicator for estimating acute blood sugar
fluctuation in patients with fulminant type 1 diabetes

  • Online:2015-11-20 Published:2015-11-20

摘要: 目的本文探讨1,5-脱水葡萄糖醇(1,5-AG)是否可以作为暴发性1型糖尿病(FT1DM)的血清学指标。方法纳入15例初
诊为FT1DM患者和73 例2 型糖尿病(T2DM)患者,检测两组的血清生物化学、糖化血红蛋白(Glycosylatedhemoglobin Alc,
HbAlc)以及血清1,5-AG等指标。结果FT1DM组与T2DM组的基本资料比较结果显示,空腹血糖(FBG)、果糖胺(FMN)、肌
酐(Cr)、尿素(Urea)、HbAlc以及血清1,5-AG存在统计学差异,P<0.05。在FT1DM患者中,血清1,5-AG水平与FBG(r=-0.646,
P=0.032)和FMN(r=-0.680,P=0.021)呈负相关。在T2DM 患者中,血清1,5-AG 与FBG、FMN 以及HbAlc 水平呈负相关
(r=-0.407,P=0.001;r=-0.314,P=0.01,r=-0.576,P<0.01)。受试者ROC曲线分析显示:血清1,5-AG曲线下面积为0.804,Cutoff
值为67.95,灵敏度和特异度分别为:82.9%和60%。结论血清1,5-AG可以反映FT1DM患者的急性血糖变化,结合患者的临床
特点和其他相关指标有利于迅速的鉴别诊断FT1DM,减少FT1DM患者的死亡率。

Abstract: Objective To test the feasibility of using 1,5-anhydroglucose alcohol (1,5-AG) as a diagnostic indicator of fulminant
type 1 diabetes (FT1DM). Methods Fifteen patients with newly diagnosed FT1DM and 52 with type 2 diabetes (T2DM) were
examined for serum biochemistry, glycosylated hemoglobin (HbAlc), and serum 1, 5-AG level. Results The patients with
FT1DM and T2DM showed significantly different fasting levels of blood glucose (FBG), fructosamine (FMN), creatinine (Cr),
urea, HbAlc and serum 1,5-AG (P<0.05). In FT1DM patients, serum 1,5-AG was found to inversely correlate with FBG
(r=-0.646, P=0.032) and FMN (r=-0.680, P=0.021), and in T2DM patients, serum 1,5-AG was inversely correlated with FBG
(r=-0.407, P=0.001), FMN (r=-0.314, P=0.01) and HbAlc (r=-0.576, P<0.01). Receiver-operating characteristic (ROC) curve analysis
showed an area under the curve of serum 1,5-AG of 0.804 with a cutoff value of 67.95, a sensitivity of 82.9% and a specificity of
60% for FT1DM diagnosis. Conclusion Serum 1, 5-AG can reflect acute blood glucose fluctuation in FT1DM patients and is
useful for differential diagnosis of FT1DM when combined with evaluations of the clinical characteristics of the patients and
other related indicators.