新竹地區糖尿病患者醣化血色素與血脂之關係

Glycosylated Hemoglobin (HbA1c) and Serum Lipids in Diabetes mellitus Patients in HsinChu Area

醣化血色素（HbA1C）可以做為糖尿病患者長期監控血糖的指標。本報告研究HbA1C是否也可以做為臨床上代謝異常的指標，因此我們分析1288位新竹地區的糖尿病患。分析的結果發現有95％以上的患者其HbA1C數值是超過參考範圍的。但是醣化血色素數值的上升並不隨著年齡的增長因而改變。再進一步的分析發現隨著醣化血色素數值的上升約有的60％左右病患血中之三酸甘油脂與50~60％左右的病患血中之膽固醇超過參考值。另外約有30~40%糖尿病患血中之三酸甘油脂和膽固醇同時超過參考值。這些結果顯示醣化血色素除了可以監測最近2~3個月血糖控制的情形，高醣化血色素也能同時反應出患者血中之三酸甘油脂和/或膽固醇有超過參考值的高度可能性。因此對糖尿病人之照顧不應只控制糖份的攝取，而忽略了對三酸甘油脂和膽固醇的監控。

Glycosylated hemoglobin (HbA1c) is known to be a practical assessment of long-termglycemic management in patients with diabetes. However, it is not known whether HbA1c has anyclinical significance in metabolic syndrome? Therefore, we examined 1288 diabetes patients in Hsin-Chuarea and discovered that the HbA1c values in more than 95% patients were higher than the referencerange. However, there was no significant correlation between the HbA1c and age. Analysis of serumtriglyceride and cholesterol levels in these subjects with abnormal HbA1c showed that the serumtriglyceride level in about 60% of these patients, the serum cholesterol level in 50~60% of these patients,and both cholesterol and triglyceride levels in 30~40% patients were higher than the reference values.These findings indicate that HbA1c reflects not only the level of glucose control over the preceding twoto three months, but also a potential marker of the rising level of triglyceride and/or cholesterol. It issuggested that the patients with abnormal HbA1c should control not only blood sugar but also triglycerideand cholesterol.