摘要
糖尿病已成为继心血管疾病和癌症之后威胁人类健康的三大杀手之一.糖化血红蛋白（glycated hemoglobin,Hb A1c）是反映血糖控制状况的重要指标,可预示并发症发生的风险,具有重要的临床研究价值.美国糖尿病协会（ADA）与世界卫生组织（WHO）于2010~2011年相继推荐其为糖尿病诊断的新标准,并采用Hb A1c≥6.5%作为临床诊断切点.中国关于Hb A1c的研究起步较晚,尚无国家化的标准检测方法,检测质量与国际标准法存在较大差距.同时,由于种群之间的差异性,国际标准所推荐的糖尿病诊断切点,不一定适用于中国人群.为此,本文综述了：a.Hb A1c的测定标准法,简介了国际及国家标准法的发展建立,以及两类标准方法的相互关系;b.Hb A1c的临床检测,概述了亲和层析法、免疫法及酶法在其测定中的应用;c.Hb A1c的即时检测,介绍了数种商业化即时检测仪的信息.旨在为促进国内Hb A1c临床检测技术的发展以及家用化Hb A1c检测仪的设计提供信息支持.
According to the latest IDF Diabetes Atlas,diabetes mellitus（DM） caused an estimated 5.1 million deaths worldwide in 2013.In other words,a person died from this epidemic disease every six seconds.DM has become one of three major causes of human death after cardiovascular disease and cancers.Glycated human hemoglobin Hb A1 cis generated by the irreversible,non-enzymatic glycation reactions on the α-amino groups of N-terminal residue Val1 in one or both beta subunits of tetrameric Hb.Due to the direct correlation of Hb A1 cwith ambient glycemic concentration over a prolonged period of time,Hb A1 ccould be useful in assessing diabetic control for the long-term,and is also an important predictor of potential risks to diabetes complications.Therefore,ADA and WHO recommended Hb A1 cwith a diagnostic cut point of ≥ 6.5% as a new diagnostic criterion for diabetes in 2010 and 2011,respectively.In this review,we summarize：（1） the standardization of Hb A1 cfrom the global IFCC reference method and designated comparison methods in the United States,Japan and Sweden;（2） the basic principles of Hb A1 cdetection methods commonly used in clinic including affinity chromatography,immunoassay and enzymatic analysis,and their application limitations;（3） the development of POC technology for Hb A1 cmeasurement.
出处
《生物化学与生物物理进展》
SCIE
CAS
CSCD
北大核心
2015年第5期443-456,共14页
Progress In Biochemistry and Biophysics
基金
国家自然科学基金(面上项目21271104
青年项目31200555)
中央高校基本科研业务费专项资金(30920140111011)资助项目~~
关键词
糖尿病
糖化血红蛋白
临床诊断
即时检测
diabetes mellitus
glycated hemoglobin（Hb A1c）
clinic diagnose
point-of-care（POC）
