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首页> 外文期刊>Diabetes care >Developing an HbA1c-based equation to estimate blood glucose in maintenance hemodialysis patients
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Developing an HbA1c-based equation to estimate blood glucose in maintenance hemodialysis patients

机译：建立基于HbA1c的方程式以估算维持性血液透析患者的血糖

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OBJECTIVE-Hemoglobin A1c (HbA1c) has been widely used as a clinically important assessment tool for outcome analyses related to glycemic control. However, because of special conditions in dialysis patients, including the uremic milieu, there is no HbA1c blood glucose (BG) equation specific for patients on dialysis. In this study, we sought to develop HbA1c-BG equation models for hemodialysis patients. RESEARCH DESIGN AND METHODS-We examined associations between HbA1c and random serum BG over time in a contemporary cohort of diabetic patients with hemodialysis treated in DaVita dialysis clinics. We identified 11,986 patients (63??12 years old and 49%male) with 69,764 paired measurements of HbA1c and BG over the course of 5 years (2001-2006). Bootstrapping method was used to estimate average BG and corresponding HbA1c levels. The association was adjusted by patient factors using linear regression. RESULTSdLinear regression analyses yielded the following three regression equations: BG = 59.2 + 29.4 ?? HbA1c 2 20.8 ?? Alb (R2 = 0.483); BG = 104.8 + 29.7 ?? HbA1c 2 18.4 ?? Alb 2 4.7 ?? Hb (R2 = 0.486); and BG = 82.9 + 30.7 ?? HbA1c 2 16.5 ?? Alb 2 5.4 ?? Hb + 0.3 ?? age + race (R2 = 0.491). All our models showed stronger association than previous equation models (R 2 = 0.468 in the Diabetes Control and Complications Trial and A 1c-Derived Average Glucose equations). CONCLUSIONS-The association between HbA1c and BG in hemodialysis patients is different than that of patients with normal kidney function. Our analysis suggests that equations including serum albumin or hemoglobin are better for hemodialysis patients. ? 2013 by the American Diabetes Association.
机译：目的-血红蛋白A1c（HbA1c）已被广泛用作临床重要的评估工具，用于与血糖控制相关的结果分析。但是，由于透析患者（包括尿毒症患者）的特殊情况，因此没有针对透析患者的HbA1c血糖（BG）方程。在这项研究中，我们寻求为血液透析患者开发HbA1c-BG方程模型。研究设计与方法-我们研究了在DaVita透析诊所接受治疗的当代糖尿病血液透析患者队列中HbA1c与随机血清BG随时间的相关性。在5年的时间（2001-2006年）中，我们确定了11,986例患者（63？12岁，男性49％），对HbA1c和BG进行了69,764次配对测量。使用自举法估算平均BG和相应的HbA1c水平。使用线性回归通过患者因素调整关联。结果d线性回归分析得出以下三个回归方程：BG = 59.2 + 29.4？ HbA1c 2 20.8 ?? Alb（R2 = 0.483）; BG = 104.8 + 29.7 ?? HbA1c 2 18.4 ?? Alb 2 4.7 ?? Hb（R2 = 0.486）;和BG = 82.9 + 30.7 ?? HbA1c 2 16.5 ?? Alb 2 5.4 ??血红蛋白+ 0.3 ??年龄+种族（R2 = 0.491）。我们所有的模型都显示出比以前的方程模型更强的关联性（糖尿病控制和并发症试验和A 1c衍生的平均葡萄糖方程中R 2 = 0.468）。结论-血液透析患者中​​HbA1c与BG的关联与肾功能正常的患者不同。我们的分析表明，对于血液透析患者，包括血清白蛋白或血红蛋白在内的方程式更好。 ？ 2013年由美国糖尿病协会颁发。

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