The related factors affecting the relationship between HbA1c and glucose management indicator in adult T2D patients with good glycemic control.

IF 2.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Pub Date : 2025-02-01 Epub Date: 2024-10-30 DOI:10.1007/s12020-024-04083-w

Zhigu Liu, Beisi Lin, Danrui Chen, Yanling Yang, Wei Jiang, Daizhi Yang, Jinhua Yan, Bin Yao, Xubin Yang, Wen Xu

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Abstract

Purpose: To explore the relationship between glucose management indicator (GMI) and HbA1c and find the affecting factors in adult T2D patients with good glycemic control.

Methods: Adult T2D patients with both HbA1c < 7% and time in range (TIR) > 70% were retrospectively analyzed. A significant difference between GMI and HbA1c was defined as an absolute value of hemoglobin glycation index (|HGI|, HbA1c minus GMI) ≥ 0.5%. Factors associated with high |HGI| were determined by logistic regression analysis. The performance of possible factors in predicting high |HGI| was verified by ROC curve analysis. And the linear relationship between GMI and HbA1c was also investigated.

Results: Of all the 94 patients (median HbA1c 6.18%, mean GMI 6.34%) included, 28.72% had an |HGI | ≥ 0.5% and only 15.96% had an |HGI | < 0.1%. Standard deviation of blood glucose (SDBG), a glycemic variability index, affected |HGI| (OR = 3.980, P = 0.001), and showed the best performance in predicting high |HGI| (AUC = 0.712, cutoff value = 1.63 mmol/L, P = 0.001). HbA1c was linearly correlated with GMI (β = 0.295, P = 0.004). Their correlation weakened after further adjusting for SDBG (β = 0.232, P = 0.012). Linear correlation between them was closer in patients with smaller SDBG ( < 1.63 mmol/L) than those with larger SDBG (P = 0.004).

Conclusions: Even in adult T2D patients with good glycemic control, the discrepancy between GMI and HbA1c existed. Their relationship was affected by glycemic variability. SDBG mainly accounted for this consequence.

Trial registration: Chinese clinical trial registry ( www.chictr.org.cn ), ChiCTR2000034884, 2020-07-23.

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影响血糖控制良好的成年 T2D 患者 HbA1c 与血糖管理指标之间关系的相关因素。

目的：探讨血糖管理指标（GMI）与 HbA1c 的关系，并找出血糖控制良好的成年 T2D 患者的影响因素：对 HbA1c 均为 70% 的成年 T2D 患者进行回顾性分析。血红蛋白糖化指数（|HGI|，HbA1c 减去血红蛋白糖化指数）的绝对值≥ 0.5%即为血红蛋白糖化指数与 HbA1c 之间存在明显差异。通过逻辑回归分析确定了与高|HGI|相关的因素。通过 ROC 曲线分析验证了可能的因素在预测高 HGI 方面的性能。此外，还研究了 GMI 与 HbA1c 之间的线性关系：结果：在纳入的所有 94 名患者（中位数 HbA1c 6.18%，平均 GMI 6.34%）中，28.72% 的患者 HGI ≥ 0.5%，只有 15.96% 的患者 HGI ≥ 0.5%：即使在血糖控制良好的成年 T2D 患者中，GMI 和 HbA1c 之间也存在差异。它们之间的关系受到血糖变化的影响。SDBG是造成这一结果的主要原因：中国临床试验注册中心 ( www.chictr.org.cn ), ChiCTR2000034884, 2020-07-23.

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.