高原人群糖化血红蛋白的研究进展_West China Medical Journal

Authors：

孙曾梅 ^1,2 , 邬云红 ² , 李秀钧 ³ ,  安力彬 ⁴

1. ;
2. ;
3. ;
4. ;

Corresponding author：

安力彬, Email: anlibin2001@163.com

Keywords：

糖化血红蛋白; 高原; 民族; 影响机制

DOI：

10.7507/1002-0179.201610143

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在多项血糖监测的指标中，糖化血红蛋白（hemoglobin A1c，HbA1c）目前是在评价血糖管理、治疗方案有效性及防控糖尿病并发症中运用最广泛且最重要的指标。然而高原低氧、低气压及民族等因素对 HbA1c 水平影响的结论仍存在争议，该文就高原环境及民族差异对 HbA1c 的具体影响及可能的机制进行了综述。

Citation： 孙曾梅, 邬云红, 李秀钧, 安力彬. 高原人群糖化血红蛋白的研究进展. West China Medical Journal, 2017, 32(12): 1935-1938. doi: 10.7507/1002-0179.201610143 Copy

1.	Syed IA. Glycated haemoglobin; past, present, and future are we ready for the change. J Pak Med Assoc, 2011, 61(4): 383-388.
2.	William HY, Gabriel U. Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. Diabetes Care, 2007, 30(10): 2453-2457.
3.	Woolcott OO, Ader M, Bergman RN. Glucose homeostasis during short-term and prolonged exposure to high altitudes. Endocr Rev, 2015, 36(2): 149-173.
4.	Allam G, Alsulaimani AA, Alghamdi H, et al. Changes in the levels of cytokines in both diabetic/non-diabetic type Ⅰ children living in a moderate altitude area in Saudi Arabia. High Alt Med Biol, 2014, 15(3): 380-387.
5.	杨历新, 米娜, 王叶, 等. 不同海拔地区非糖尿病成人糖化血红蛋白水平及影响因素的研究. 中华内分泌代谢杂志, 2012, 28(5): 412-413.
6.	Hessien M. Improved glycemic control in moderate altitude type Ⅱ diabetic residents. High Alt Med Biol, 2013, 14(1): 27-30.
7.	Sayarlioglu H, Erkoc R, Dogan E, et al. Nephropathy and retinopathy in type 2 diabetic patients living at moderately high altitude and sea level. Ren Fail, 2005, 27(1): 67-71.
8.	Ju HB, Yang LP, Fan Jian, et al. Comparison of blood sugar and glycosylated hemoglobin in type 2 diabetic patients of Chinese provinces at different altitudes. Biomed Res, 2014, 25(3): 311-316.
9.	Pavan P, Sarto P, Merlo L, et al. Metabolic and cardiovascular parameters in type 1 diabetes at extreme altitude. Med Sci Sports Exerc, 2004, 36(8): 1283-1289.
10.	姚勇利, 白秀玲. 高原地区红细胞增多人群血红蛋白与 HbA1c 关系的初步研究. 高原医学杂志, 2006, 16(2): 31-32.
11.	鞠海兵, 徐昕明, 舒子正, 等. 昆明市 2 型糖尿病患者糖化血红蛋白相关因素分析. 中国糖尿病杂志, 2013, 21(8): 692-694.
12.	杨丽萍, 鞠海兵, 陈宗宁, 等. 丽江地区 2 型糖尿病患者糖化血红蛋白相关因素分析. 中国综合临床, 2013, 29(3): 243-245.
13.	Mcclain DA, Abuelgasim KA, Nouraie M, et al. Decreased serum glucose and glycosylated hemoglobin levels in patients with Chuvash polycythemia: a role for HIF in glucose metabolism. J Mol Med (Berl), 2013, 91(1): 59-67.
14.	Wagner PD, Simonson TS, Wei G, et al. Sea-level haemoglobin concentration is associated with greater exercise capacity in Tibetan males at 4200 m. Exp Physiol, 2015, 100(11): 1256-1262.
15.	张惠莉, 祁红英. 糖化血红蛋白及其在高海拔地区的相关研究. 中华老年多器官疾病杂志, 2014, 13(11): 876-880.
16.	Lee SC, Wang LH, Tsai SM, et al. Effects of the Hb E, Hb H and Hb G-Taichung variants on HbA1c values by the Bio-Rad variant II turbo analyzer. Clin Biochem, 2011, 44(16): 1338-1342.
17.	Little RR, Rohlfing CL, Hanson S, et al. Effects of hemoglobin (Hb) E and HbD traits on measurements of glycated Hb (HbA1c) by 23 methods. Clin Chem, 2008, 54(8): 1277-1282.
18.	贾礼华, 陈江华. 高原成年人贫血状况分布调查与分析. 国际检验医学杂志, 2016, 37(11): 1503-1505.
19.	Umar Z, Rasool M, Asif M, et al. Evaluation of hemoglobin concentration in pregnancy and correlation with different altitude: a study from balochistan plateau of Pakistan. Open Biochem J, 2015, 9: 7-14.
20.	Shanthi B, Revathy C, Manjula Devi AJ. Effect of iron deficiency on glycation of haemoglobin in nondiabetics. J Clin Diagn Res, 2013, 7(1): 15-17.
21.	Kutter D, Thoma J. Hereditary spherocytosis and other hemolytic anomalies distort diabetic control by glycated hemoglobin. Clin Lab, 2006, 52(9/10): 477-481.
22.	Samaja M, Brenna L, Allibardi S, et al. Human red blood cell aging at 5,050-m altitude a role during adaptation to hypoxia. Am Physiol Soc, 1993, 75(4): 1696-1701.
23.	Thalmann S, Gojanovic B, Jornayvaz FR, et al. The diabetic patient at altitude: pathophysiology and practical implications. Rev Med Suisse, 2007, 3(114): 1463-1466, 1468.
24.	杨艳, 余善法, 姜开友. 职业应激与糖化血红蛋白的关系. 中华劳动卫生职业病杂志, 2011, 29(12): 898-901.
25.	Woods DR, Stacey M, Hill N, et al. Endocrine aspects of high altitude acclimatization and acute mountain sickness. J R Army Med Corps, 2011, 157(1): 33-37.
26.	Pani LN, Korenda L, Meigs JB, et al. Effect of aging on A1C levels in individuals without diabetes. Diabetes Care, 2008, 31(10): 1991-1996.
27.	李海英, 朱润生. 西藏地区糖尿病病人空腹血糖与 HbA1c 关系的分析. 实用糖尿病杂志, 2006, 3(2): 15-16.
28.	鞠海兵, 杨丽萍, 樊剑, 等. 云南不同海拔不同民族糖尿病患者血糖和糖化血红蛋白的比较. 中国医师杂志, 2014, 16(5): 631-633.
29.	李宗霞. 不同海拔地区人群糖化血红蛋白值的比较分析. 现代预防医学, 2012, 39(6): 1519-1520.
30.	Batchuluun B, Matsumata T, Batchuluun B, et al. Serum ferritin level is higher in poorly controlled patients with type 2 diabetes and people without diabetes, aged over 55 years. Diabet Med, 2014, 31(4): 419-424.
31.	Chen X, Scholl TO, Stein TP. Association of elevated serum ferritin levels and the risk of gestational diabetes mellitus in pregnant women: the Camden study. Diabetes Care, 2006, 29(5): 1077-1082.
32.	Wang Z, Dang S, Yan H. Nutrient intakes of rural Tibetan mothers: a cross-sectional survey. BMC Public Health, 2010, 10(1): 801.
33.	Hintze KJ, Mcclung JP. Hepcidin: a critical regulator of iron metabolism during hypoxia. Adv Hematol, 2011: 510304.
34.	Veigne SW, Sobngwi E, Nouthe BE, et al. Study of the effect of altitude on the measurement of glycated haemoglobin using point-of-care instruments. Cardiovasc J Afr, 2015, 26(1): 38-40.
35.	Nathan DM, Buse JB, Davidson MB, et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care, 2009, 32(1): 193-203.
36.	中华医学会糖尿病分会. 中国糖尿病防治指南. 北京: 北京大学医学出版社, 2016: 63.

1. Syed IA. Glycated haemoglobin; past, present, and future are we ready for the change. J Pak Med Assoc, 2011, 61(4): 383-388.
2. William HY, Gabriel U. Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. Diabetes Care, 2007, 30(10): 2453-2457.
3. Woolcott OO, Ader M, Bergman RN. Glucose homeostasis during short-term and prolonged exposure to high altitudes. Endocr Rev, 2015, 36(2): 149-173.
4. Allam G, Alsulaimani AA, Alghamdi H, et al. Changes in the levels of cytokines in both diabetic/non-diabetic type Ⅰ children living in a moderate altitude area in Saudi Arabia. High Alt Med Biol, 2014, 15(3): 380-387.
5. 杨历新, 米娜, 王叶, 等. 不同海拔地区非糖尿病成人糖化血红蛋白水平及影响因素的研究. 中华内分泌代谢杂志, 2012, 28(5): 412-413.
6. Hessien M. Improved glycemic control in moderate altitude type Ⅱ diabetic residents. High Alt Med Biol, 2013, 14(1): 27-30.
7. Sayarlioglu H, Erkoc R, Dogan E, et al. Nephropathy and retinopathy in type 2 diabetic patients living at moderately high altitude and sea level. Ren Fail, 2005, 27(1): 67-71.
8. Ju HB, Yang LP, Fan Jian, et al. Comparison of blood sugar and glycosylated hemoglobin in type 2 diabetic patients of Chinese provinces at different altitudes. Biomed Res, 2014, 25(3): 311-316.
9. Pavan P, Sarto P, Merlo L, et al. Metabolic and cardiovascular parameters in type 1 diabetes at extreme altitude. Med Sci Sports Exerc, 2004, 36(8): 1283-1289.
10. 姚勇利, 白秀玲. 高原地区红细胞增多人群血红蛋白与 HbA1c 关系的初步研究. 高原医学杂志, 2006, 16(2): 31-32.
11. 鞠海兵, 徐昕明, 舒子正, 等. 昆明市 2 型糖尿病患者糖化血红蛋白相关因素分析. 中国糖尿病杂志, 2013, 21(8): 692-694.
12. 杨丽萍, 鞠海兵, 陈宗宁, 等. 丽江地区 2 型糖尿病患者糖化血红蛋白相关因素分析. 中国综合临床, 2013, 29(3): 243-245.
13. Mcclain DA, Abuelgasim KA, Nouraie M, et al. Decreased serum glucose and glycosylated hemoglobin levels in patients with Chuvash polycythemia: a role for HIF in glucose metabolism. J Mol Med (Berl), 2013, 91(1): 59-67.
14. Wagner PD, Simonson TS, Wei G, et al. Sea-level haemoglobin concentration is associated with greater exercise capacity in Tibetan males at 4200 m. Exp Physiol, 2015, 100(11): 1256-1262.
15. 张惠莉, 祁红英. 糖化血红蛋白及其在高海拔地区的相关研究. 中华老年多器官疾病杂志, 2014, 13(11): 876-880.
16. Lee SC, Wang LH, Tsai SM, et al. Effects of the Hb E, Hb H and Hb G-Taichung variants on HbA1c values by the Bio-Rad variant II turbo analyzer. Clin Biochem, 2011, 44(16): 1338-1342.
17. Little RR, Rohlfing CL, Hanson S, et al. Effects of hemoglobin (Hb) E and HbD traits on measurements of glycated Hb (HbA1c) by 23 methods. Clin Chem, 2008, 54(8): 1277-1282.
18. 贾礼华, 陈江华. 高原成年人贫血状况分布调查与分析. 国际检验医学杂志, 2016, 37(11): 1503-1505.
19. Umar Z, Rasool M, Asif M, et al. Evaluation of hemoglobin concentration in pregnancy and correlation with different altitude: a study from balochistan plateau of Pakistan. Open Biochem J, 2015, 9: 7-14.
20. Shanthi B, Revathy C, Manjula Devi AJ. Effect of iron deficiency on glycation of haemoglobin in nondiabetics. J Clin Diagn Res, 2013, 7(1): 15-17.
21. Kutter D, Thoma J. Hereditary spherocytosis and other hemolytic anomalies distort diabetic control by glycated hemoglobin. Clin Lab, 2006, 52(9/10): 477-481.
22. Samaja M, Brenna L, Allibardi S, et al. Human red blood cell aging at 5,050-m altitude a role during adaptation to hypoxia. Am Physiol Soc, 1993, 75(4): 1696-1701.
23. Thalmann S, Gojanovic B, Jornayvaz FR, et al. The diabetic patient at altitude: pathophysiology and practical implications. Rev Med Suisse, 2007, 3(114): 1463-1466, 1468.
24. 杨艳, 余善法, 姜开友. 职业应激与糖化血红蛋白的关系. 中华劳动卫生职业病杂志, 2011, 29(12): 898-901.
25. Woods DR, Stacey M, Hill N, et al. Endocrine aspects of high altitude acclimatization and acute mountain sickness. J R Army Med Corps, 2011, 157(1): 33-37.
26. Pani LN, Korenda L, Meigs JB, et al. Effect of aging on A1C levels in individuals without diabetes. Diabetes Care, 2008, 31(10): 1991-1996.
27. 李海英, 朱润生. 西藏地区糖尿病病人空腹血糖与 HbA1c 关系的分析. 实用糖尿病杂志, 2006, 3(2): 15-16.
28. 鞠海兵, 杨丽萍, 樊剑, 等. 云南不同海拔不同民族糖尿病患者血糖和糖化血红蛋白的比较. 中国医师杂志, 2014, 16(5): 631-633.
29. 李宗霞. 不同海拔地区人群糖化血红蛋白值的比较分析. 现代预防医学, 2012, 39(6): 1519-1520.
30. Batchuluun B, Matsumata T, Batchuluun B, et al. Serum ferritin level is higher in poorly controlled patients with type 2 diabetes and people without diabetes, aged over 55 years. Diabet Med, 2014, 31(4): 419-424.
31. Chen X, Scholl TO, Stein TP. Association of elevated serum ferritin levels and the risk of gestational diabetes mellitus in pregnant women: the Camden study. Diabetes Care, 2006, 29(5): 1077-1082.
32. Wang Z, Dang S, Yan H. Nutrient intakes of rural Tibetan mothers: a cross-sectional survey. BMC Public Health, 2010, 10(1): 801.
33. Hintze KJ, Mcclung JP. Hepcidin: a critical regulator of iron metabolism during hypoxia. Adv Hematol, 2011: 510304.
34. Veigne SW, Sobngwi E, Nouthe BE, et al. Study of the effect of altitude on the measurement of glycated haemoglobin using point-of-care instruments. Cardiovasc J Afr, 2015, 26(1): 38-40.
35. Nathan DM, Buse JB, Davidson MB, et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care, 2009, 32(1): 193-203.
36. 中华医学会糖尿病分会. 中国糖尿病防治指南. 北京: 北京大学医学出版社, 2016: 63.

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