HbA와 당뇨병의 헤모글로민 농도에 의한 당 평균 추정값 사이의 관계
Relationship Between HbA1c and Estimated Average Glucose by Hemoglobin Concentration of Diabetic Patients
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Abstract
Glycated hemoglobin (HbA1c) is a most preferably used baseline of diabetes, implicating average blood glucose levels over a 2-3 month period of time. Recently the American Diabetes Association has recommended the HbA1c assay as one of the criteria for diabetes. Although some studies provide data with “estimated average glucose”, by converting the HbA1c results from simple linear regression, the results are not applicable to whole diabetes. We compared the relationship between HbA1c and estimated average glucose by anemia degree of diabetic patients in Korea. The data from the 2008~2009 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 1,257 diabetes subjects with HbA1c results. The distribution of subjects was 34.1% in 60’s, 25.9% in 70’s, 21,6% in 50’s, showing that there was more than 80% in over 50’s. To take a close look of the differences depending on the anemic degree, we applied WHO criteria (hemoglobin<13.0 in men and hemoglobin<12.0 in women) and divided anemia degree. The regression equation for A1c and estimated average glucose was eAGmg/dL=24.3×A1c-32.0 (R2=0.54, p<0.001) in all subjects, eAGmg/dL=33.1×A1c-96.1 (R2=0.52, p<0.001) in slight anemia (11.0≤Hb<13.0 in men, 10.0≤Hb<12.0 in women), and eAGmg/dL=13.5×A1c+34.9 (R2=0.12, p =0.075) in moderate anemia (Hb<11.0 in men, Hb<10.0 in women). The regression was not significant in moderate anemia. The relationship between HbA1c and eAG was lower correlation than ADAG study, and eAG showed lower value in all ranges among HbA1c 5~13%. Such as a korea where, there are many diabetic patients among the old aged and higher prevalence rate of anemia, we should be extra careful when we reflect eAG using HbA1c and need to establish criteria which can be applicable to koreans.
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