The clinical application of glycosylated hemoglobin A1c and glycated albumin values in cirrhosis patients with hyperglycemia / 中华内科杂志

ABSTRACT

Objective To evaluate the diagnostic value of glycosylated hemoglobin A1c (HbA1c)and glycated albumin(GA) in hyperglycemia patients with liver cirrhosis (LCH).Methods One hundred LCH patients were divided into anemia and no-anemia group by Hb 110 g/L The no-anemia group was further divided into low albumin (serum albumin ＜ 30 g/L),and high albumin group (serum albumin 30-＜40 g/L).One hundred type 2 diabetes without liver cirrhosis were included as control group (T2DM).HbA1c,GA,fasting plasma glucose (FPG),postprandial 2h plasma glucose (2hPG) were collected for statistical analysis.Results (1) The HbA1c level in LCH with anemia tended lower than that in T2DM subjects [(6.76 ±2.20)％ vs (7.34 ± 1.23)％,P =0.06];though the level of GA [(19.10 ±7.47)％vs (16.68 ±2.90)％,P＜0.01] and 2hPG [(12.09 ±3.39) mmol/L vs (10.84 ±2.95) mmol/L,P＜0.05] were significantly higher than that in T2DM group.(2) No-anemia subjects in LCH group with albumin ＜ 30 g/L had obviously higher GA levels than those with albumin 30-＜ 40 g/L and T2DM (albumin≥40 g/L) [(18.79 ±2.28)％ vs (16.71 ±2.42)％ and (16.73 ±2.96)％,P＜0.01];though the level of HbA1c of three groups above has no significant difference.(3) The level of HbA1c between LCH without anemia group and T2DM group had no significant difference (P ＞ 0.05);and the level of GA between LCH without anemia group with albumin 30-＜ 40 g/L and T2DM group had no significant difference(P ＞0.05).(4) The HbA1c has a positive correlation with FPG and 2hPG in LCH (FPG∶r =0.45,P＜0.001;2hPG∶r =0.33,P=0.001) and T2DM subjects (FPG∶ r =0.76,P＜0.001;2hPG∶r =0.81,P ＜ 0.001).GA also has a positive correlation with FPG and 2hPG in LCH (FPG∶ r =0.48,P ＜0.001;2hPGr=0.39,P ＜0.001) and T2DM subjects (FPG∶ r =0.74,P ＜0.001;2hPG∶ r =0.76,P ＜0.001).Conclusion It is unfavorable to use HbA1c to evaluate the blood glucose level in liver cirrhosis patients with Hb ＜ 110 g/L and to use GA in patients with serum albumin ＜ 30 g/L.