단시간의 혈당량 변화에 따른 당화혈색소량의 변동 = The Short Term Changes of Hemoglobin A1c Values in NIDDM Patients

다국어 초록 (Multilingual Abstract)

Background : HbA_1C is formed slowly throughout the 120-day life span of the red blood cell by non-enzymatic glycosylation of HbA_O. HbA_1C concentrations reflect mean blood glucose levels over the previous several weeks, but we experienced the changes of hemoglobin A_1C values according to the short term changes of blood glucose levels. We investigated the changes of HbA_1C values with a HPLC technique according to the short term changes of blood glucose concentration. Method : HbA_1C values were measured at fasting and postprandial 2-hour state with a HPLC method in 166 NIDDM patients, and they are divided into three groups (Group Ⅰ : ??HbA_1C<-0.3%, Group Ⅱ : ??HbA_1C>0.3%, Group Ⅲ : -0.3%≤??HbA_1C≤0.3, ??HbA_1C : postprandial 2 hour HbAlc values-fasting HbA_1C values) and compared respectively. In 15 untreated NIDDM patients, blood glucose and HbA_1C were measured during the oral glucose tolerance test to exclude the influence of food and treatment on the HPLC method. Stable HbA_1C and labile HbA_1C were measured in 37 NIDDM patients to evaluate the influence of labile HbAlC on the HPLC method. Results : 1) In group Ⅰ, Ⅱ, Ⅲ, Postprandial 2-hour blood glucose levels (man±SEM) were 185.1±33.42mg/dl, 306. different respectively (p<0.01). fasting blood glucose levels, fasting HbA_1C values and postprandial 2-hour HbA_1C values were not significantly different among three gruops. 2) In group Ⅰ, Ⅱ, Ⅲ, the differences between postprandial 2-hour levels and fasting blood glucose levels were -79.8±43.79mg/dl, 103.2±14.61mg/dl, 42.9±11.17mg/dl, and the differences were highly significant (p<0.001). The mean ??HbA_1C values were -0.6±0.49%, 0.6±0.33, 0.08±0.01% respectively. 3) In 15 untreated NIDDM patients, HbA_1C values were significantly increased from 7.2±1.3% to 7.8±1.9% according to the increment of blood glucose levels from 164.1±9.61mg/dl to 285.3±14.42mg/dl (p<0.001), but stable HbA_1C values were not significantly changed. 5) Correlation between labile HbA_1C and blood glucose (r=0.41, p<0.001) was higher than that between stable HbA_1C and blood glucose (r=0.28, p<0.001). Conclusion :From the above results we can find that HbA_1C values measured with a HPLC technique change according to the short term changes of blood glucose levels, and the changes of HbA_1C values are caused by the short term changes of labile HbA_1C values.