以糖化血色素診斷糖尿病

Application of Glycosylated Hemoglobin in the Diagnosis of Diabetes Mellitus

盧佳怡(Chai-Yei Lu) ； 張美智(Mei-Chi Chang) ； 林光洋(Kuang-Yang Lin)

《北市醫學雜誌》 7卷2期 (2010/06) Pp. 109-118

https://doi.org/10.6200/TCMJ.2010.7.2.01

摘要

糖尿病是一種代謝異常的慢性病，大多呈現明顯的高血糖，嚴格的控制血糖，可減少慢性併發症的發生和醫療資源的耗費，因此早期診斷是很重要的。糖尿病診斷一向以血糖濃度為主要依據，血糖值會高低起伏，而糖化血色素是一種加權平均血糖濃度，起伏幅度較小，曾有學者建議以此當作診斷糖尿病的工具，但各實驗室產生的數據不同，後經美國全國糖化血色素標準化委員會致力於檢測方法的標準化，經數次的會議討論，標準化終於獲得確認，其糖化血色素值與糖尿病控制併發症試驗計畫和英國糖尿病前瞻性的研究結果相稱，進而全球普遍使用。美國糖尿病學會於2010年，增列糖化血色素大於或等於6.5%當作糖尿病診斷標準，在臨床醫療上的診斷多一項選擇。

關鍵字

糖尿病 ； 糖化血色素 ； 糖尿病診斷

並列摘要

Diabetes mellitus (DM) is a chronic disease characterized by abnormal carbohydrate metabolism, most notably hyperglycemia, and has an associated heightened risk of long-term complications. Intensive glycemic control can reduce the microvascular complications of diabetes and thus lower medical expenditure. Early diagnosis of diabetes is important. All methods previously used for the diagnosis of diabetes have relied on measuring blood glucose concentration, which fluctuates over time. Glycosylated hemoglobin (A1c) represents the integrated glucose concentration over the preceding two to three months and therefore does not fluctuated in the same way as daily blood glucose levels. Different laboratory A1c assay methods have resulted in extensive variations in A1c values. Standardization of A1c measurements by The National Glycohemoglobin Standards Program (NGSP) has significantly reduced this variation in A1c measurements across laboratories. NGSP-A1c is aligned to the DCCT/UKPDS and is better standardized; as a result NGSP-A1c certified methods are used worldwide. Therefore, the American Diabetes Association recommends use NGSP-A1c for the diagnosis of diabetes. In 2010, the ”Standards of Medical Care in Diabetes” were revised to include the use of A1c measurement as a diagnosis method for diabetes, with a cutoff point of≧6.5%. In conclusion, the use of A1c measurements for diabetes diagnosis is helpful.

並列關鍵字

diabetes mellitus ； glycosylated hemoglobin ； diagnosis of diabetes mellitus