Diabetologia：铁缺乏导致HbA1c水平升高假象

2015-07-07 沐晴 MedSci原创

目的：尽管使用HbA1c来诊断糖尿病已得到广泛认可，但是不可否认，HbA1c的水平受很多因素影响。贫血是主要的影响因素之一。关于红细胞指数及贫血的程度对HbA1c的影响仍不清楚。方法：<span style="font-size: 12.0pt;font-weight:normal;mso-bidi-font-weight:bold">研究者对1990年1月至2014年5月期间，MEDL

目的：尽管使用HbA1c来诊断糖尿病已得到广泛认可，但是不可否认，HbA1c的水平受很多因素影响。贫血是主要的影响因素之一。关于红细胞指数及贫血的程度对HbA1c的影响仍不清楚。

方法：研究者对1990年1月至2014年5月期间，MEDLINE, EMBASE，Nursing & Allied Health Literature电子数据库和Cochrane图书馆中出版的相关文章，进行一一筛查，筛查条件是：研究中至少包括一项HbA1c和血糖的检测值，至少一项提示血色素缺乏的指标，研究对象是非妊娠的、否认糖尿病史成年人。

结果：一共搜索到544篇文章，最后筛选出12篇进行分析，大多数的研究都聚焦在缺铁性贫血（IDA）。最终结果显示，与对照组相比，试验组不论是否存在贫血，铁缺乏都会导致HbA1c水平升高，但是并不伴随血糖水平的升高。另外，关于红细胞畸形对HbA1c影响的数据非常有限，目前研究数据提示非缺铁性贫血者HbA1c水平可能会降低。结论：在铁缺乏和缺铁性贫血的状态下，HbA1c水平可能出现假象的上升；反之，非缺铁性贫血可能导致HbA1c水平降低。这项结果令使用HbA1c诊断糖尿病受到质疑，将来需要更多的研究证据，尤其是明确贫血的类型和程度对HbA1c可靠性的显著影响。

原始出处：

E English, I Idris, G Smith,et al. Diabetologia.The Effect of Anaemia and Abnormalities of Erythrocyte Indices on HbA1c Analysis: A Systematic Review.Diabetologia 2015 Jul 01;58(7)1409-1421

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2016-03-27 Smile2680

#HbA#

36 0
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2016-01-14 ms9608593228839890

#DIA#

33 0
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2016-04-14 ms5439512287675881

#BET#

43 0
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2015-07-09 ms920641618706883

#铁缺乏#

43 0
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2015-07-08 huaxipanxing

看看

163 0
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2015-07-08 保守主义

我去，不知道靠谱么

63 0
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2015-07-08 保守主义

以后临床可以考虑考虑

137 0

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