四川省遂宁地区表观健康成年人群血浆FMN,FMN/TP比值及FMN/ALB比值参考区间的建立
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摘要
目的建立四川省遂宁地区表观健康成年人群血浆果糖胺(fructosamine,FMN)、果糖胺/总蛋白比值(fructosamine to total protein ratio,FMN/TP)及果糖胺/清蛋白比值(fructosamine to albumin ratio,FMN/ALB)的参考区间。方法选取2017年1～12月遂宁市中心医院健康管理中心14 639例20～79岁的表观健康成年人作为研究对象,其中男性4 811例,女性9 828例,通过问卷调查、体格检查、超声及实验室检查排除呼吸系统、血液系统、内分泌系统、炎症和肿瘤等疾病,检测其血浆FMN、总蛋白(total protein,TP)和清蛋白(albumin,ALB)的浓度并计算该人群FMN/TP及FMN/ALB的浓度水平。根据性别和年龄将研究对象分组(男女各6组:20～29岁组,30～39岁组,40～49岁组,50～59岁组,60～69岁组和70～79岁组),对各组检测结果进行统计学分析,浓度水平差异无统计学意义的各组数据进行合并后,呈正态分布则以均值±1.96标准差■建立该地区表观健康人群血浆中FMN,FMN/TP及FMN/ALB的参考区间;呈偏态分布以百分位数法(P_(2.5)～P_(97.5))建立其参考区间。结果男性血浆FMN,FMN/TP及FMN/ALB浓度水平依次为1.7(1.6～1.8)mmol/L,22.0(20.7～23.5)μmol/g和37.1(34.5～39.8)μmol/g;女性则依次为1.7(1.6～1.8)mmol/L,22.4(21.1～23.9)μmol/g和38.5(36.2～41.2)μmol/g。男性和女性血浆FMN,FMN/TP及FMN/ALB浓度水平均呈偏态分布(P<0.05),且两组间比较差异均具有统计学意义(P<0.01)。进一步分析,男性和女性各年龄组血浆FMN,FMN/TP及FMN/ALB浓度水平的中位数与其总体区间中位数的差异均<25%,故不建议按年龄段分组建立参考区间,可仅按性别分组建立其参考区间。FMN的参考区间:男性为1.4～2.0 mmol/L,女性为1.5～2.0 mmol/L;FMN/TP的参考区间:男性为18.2～26.4μmol/g,女性为18.9～26.8μmol/g;FMN/ALB的参考区间:男性为30.4～46.1μmol/g,女性为32.1～46.9μmol/g。结论初步建立了遂宁地区20～79岁表观健康人群血浆FMN,FMN/TP及FMN/ALB的参考区间,为临床应用其作为糖尿病患者的诊断及疗效评估指标提供依据。
Objective To establish the reference intervals of fructosamine(FMN),fructosamine to total protein ratio(FMN/TP)and fructosamine to albumin ratio(FMN/ALB)in peripheral blood plasma of apparently healthy adult population in Suining of Sichuan.Methods From January to December 2017,14 639 apparent healthy adults aged 20 to 79 years old in the Health Management Center of Suining Central Hospital were selected as the research objects,including 4 811 males and 9 828 females.Through questionnaire survey,physical examination,ultrasound and laboratory examination,diseases such as respiratory system,blood system,endocrine system,inflammation and tumor were excluded from the research objects.And then detected the concentration of plasma FMN,TP,ALB,and calculated standard of the concentration about FMN/TP and FMN/ALB.The subject were grouped that according to gender and age(divided into six age groups for men and women:20～29 years old group,30～39 years old group,40～49 years old group,50～59 years old group,60～69 years old group,70～79 years old group).The results were statistically analyzed.The data of each group that with none statistically significant difference in concentration level would be combined.If the data of group in normal distribution,the reference intervals of FMN,FMN/TP and FMN/ALB in plasma of the apparently healthy population in this region were established with mean ±1.96s standard deviation ■.In skewed distribution,established reference interval were established by percentiles(P_(2.5)～P_(97.5)).Results The concentration level of plasma FMN,FMN/TP and FMN/ALB were 1.7(1.6～1.8) mmol/L,22.0(20.7～23.5) μmol/g,37.1(34.5～39.8) μmol/g for men,(34.5～39.8) μmol/g,1.7(1.6～1.8) mmol/L,22.4(21.1～23.9) μmol/g and 38.5(36.2～41.2) μmol/g for women,respectively.The concentrations level of FMN,FMN/TP and FMN/ALB in male and female plasma presented by skewed distribution(P<0.05),and the difference between two groups was statistically significant(P<0.01).Further analysis,difference value were <25%,between the age group median and the overall intervals median in plasma concentration of FMN,FMN/TP and FMN/ALB in the male &females.Therefore,shouldn't advise to establish reference interval by range of ages.Could established reference interval by gender.The reference interval with FMN:1.4～2.0 mmol/L for men and 1.5～2.0 mmol/L for women.The reference interval of FMN/TP:18.2～26.4 μmol/g for men and 18.9～26.8 μmol/g for women,and the reference interval of FMN/ALB:30.4～46.1 μmol/g for men and 32.1～46.9 μmol/g for women.Conclusion The reference ranges of plasma FMN,FMN/TP and FMN/ALB in the apparently healthy population aged 20～79 in Suining region have been preliminarily established,which provides a basis of clinical application for diagnosis and therapy in diabetic patients.
Objective To establish the reference intervals of fructosamine(FMN),fructosamine to total protein ratio(FMN/TP)and fructosamine to albumin ratio(FMN/ALB)in peripheral blood plasma of apparently healthy adult population in Suining of Sichuan.Methods From January to December 2017,14 639 apparent healthy adults aged 20 to 79 years old in the Health Management Center of Suining Central Hospital were selected as the research objects,including 4 811 males and 9 828 females.Through questionnaire survey,physical examination,ultrasound and laboratory examination,diseases such as respiratory system,blood system,endocrine system,inflammation and tumor were excluded from the research objects.And then detected the concentration of plasma FMN,TP,ALB,and calculated standard of the concentration about FMN/TP and FMN/ALB.The subject were grouped that according to gender and age(divided into six age groups for men and women:20～29 years old group,30～39 years old group,40～49 years old group,50～59 years old group,60～69 years old group,70～79 years old group).The results were statistically analyzed.The data of each group that with none statistically significant difference in concentration level would be combined.If the data of group in normal distribution,the reference intervals of FMN,FMN/TP and FMN/ALB in plasma of the apparently healthy population in this region were established with mean ±1.96s standard deviation ■.In skewed distribution,established reference interval were established by percentiles(P_(2.5)～P_(97.5)).Results The concentration level of plasma FMN,FMN/TP and FMN/ALB were 1.7(1.6～1.8) mmol/L,22.0(20.7～23.5) μmol/g,37.1(34.5～39.8) μmol/g for men,(34.5～39.8) μmol/g,1.7(1.6～1.8) mmol/L,22.4(21.1～23.9) μmol/g and 38.5(36.2～41.2) μmol/g for women,respectively.The concentrations level of FMN,FMN/TP and FMN/ALB in male and female plasma presented by skewed distribution(P<0.05),and the difference between two groups was statistically significant(P<0.01).Further analysis,difference value were <25%,between the age group median and the overall intervals median in plasma concentration of FMN,FMN/TP and FMN/ALB in the male &females.Therefore,shouldn't advise to establish reference interval by range of ages.Could established reference interval by gender.The reference interval with FMN:1.4～2.0 mmol/L for men and 1.5～2.0 mmol/L for women.The reference interval of FMN/TP:18.2～26.4 μmol/g for men and 18.9～26.8 μmol/g for women,and the reference interval of FMN/ALB:30.4～46.1 μmol/g for men and 32.1～46.9 μmol/g for women.Conclusion The reference ranges of plasma FMN,FMN/TP and FMN/ALB in the apparently healthy population aged 20～79 in Suining region have been preliminarily established,which provides a basis of clinical application for diagnosis and therapy in diabetic patients.
引文
[1] JUNG M,WARREN B,GRAMS M,et al.Performance of non-traditional hyperglycemia biomarkers by chronic kidney disease status in older adults with diabetes:results from the atherosclerosis risk in communities study[J].Journal of Diabetes,2018,10(4):276-285.
[2] PARRINELLO C M,SHARRETT A R,MARUTHUR N M,et al.Racial differences in and prognostic value of biomarkers of hyperglycemia[J].Diabetes care,2016,39(4):589-595.
[3] 季雄娟,邵静,陆胜.糖化血红蛋白及糖化清蛋白水平对糖尿病视网膜病变的诊断价值分析[J].现代检验医学杂志,2018,33(5):77-81. JI Xiongjuan,SHAO Jing,LU Sheng.Diagnostic value of glycocsylated hemoglobin A1cand glycated albumin levels in diabetic retinopany[J].J Mod Lab Med,2018,33(5):77-81.
[4] 杨琳,肖光军,杨洪,等.血浆与血清样本果糖胺检测结果的比较分析[J].医学信息,2018,31(19):158-160. YANG Lin,XIAO Guangjun,YANG Hong,et al.Comparative analysis of the results of detection of fructosamine in plasma and serum samples[J].Medical Information,2018,31(19):158-160.
[5] 陈立新,张靖宇,王丽芳,等.果糖胺/血浆清蛋白与果糖胺/血浆总蛋白在糖尿病诊断中的价值比较[J].国际检验医学杂志,2017,38(16):2288-2290. CHEN Lixin,ZHANG Jingyu,WANG Lifang,et al.Comparison of the value of fructosamine to albumin ratio and fructosamine to total protein ratio in the diagnosis of diabetes mellitus[J].Int J Lab Med,2017,38(16):2288-2290.
[6] 张丽红,黄婷婷.果糖胺/血清蛋白比值对糖尿病的诊断价值[J].中国糖尿病杂志,2015,23(10):912-914. ZHANG Lihong,HUANG Tingting.The value of fructosamine/serum protein ratio in diagnosis of diabetes mellitus[J].Chinese Journal of Diabetes,2015,23(10):912-914.
[7] 中华人民共和国国家卫生和计划生育委员会.WS/T402-2012:临床实验室检验项目参考区间的制定[S].北京:中国标准出版社,2013. Ministry Health and Family Planning Commission of the People’s Republic of China.WS/T402-2012:Define and determine the reference intervals in clinical laboratory[S].Beijing:China Standard Press,2013.
[8] 高原,杨剑敏,王欢,等.上海市区2 408例健康儿童末梢血血常规参数的参考区间调查分析[J].检验医学,2012,27(3):217-220. GAO Yuan,YANG Jianmin,WANG Huan,et al.Survey analysis on the routine reference intervals of peripheral blood determination among 2 408 healthy children in Shanghai[J].Laboratory Medicine,2012,27(3):217-220.
[9] 章晓燕,王薇,何法霖,等.全国网织红细胞计数参考区间和决定限现状调查与分析[J].现代检验医学杂志,2016,31(3):158-161.ZHANG Xiaoyan,WANG Wei,HE Falin,et al.Investigation and analysis of reference intervals and decision limits of reticulocyte count in China[J].J Mod Lab Med,2016,31(3):158-161.
[10] 段敏,赵海建,王薇,等.临床检验参考区间和决定限的质量要求[J].现代检验医学杂志,2017,32(5):148-151. DUAN Min,ZHAO Haijian,WANG Wei,et al.Quality requirements for reference intervals and decision limits in clinical laboratory[J].J Mod Lab Med,2017,32(5):148-151.
[2] PARRINELLO C M,SHARRETT A R,MARUTHUR N M,et al.Racial differences in and prognostic value of biomarkers of hyperglycemia[J].Diabetes care,2016,39(4):589-595.
[3] 季雄娟,邵静,陆胜.糖化血红蛋白及糖化清蛋白水平对糖尿病视网膜病变的诊断价值分析[J].现代检验医学杂志,2018,33(5):77-81. JI Xiongjuan,SHAO Jing,LU Sheng.Diagnostic value of glycocsylated hemoglobin A1cand glycated albumin levels in diabetic retinopany[J].J Mod Lab Med,2018,33(5):77-81.
[4] 杨琳,肖光军,杨洪,等.血浆与血清样本果糖胺检测结果的比较分析[J].医学信息,2018,31(19):158-160. YANG Lin,XIAO Guangjun,YANG Hong,et al.Comparative analysis of the results of detection of fructosamine in plasma and serum samples[J].Medical Information,2018,31(19):158-160.
[5] 陈立新,张靖宇,王丽芳,等.果糖胺/血浆清蛋白与果糖胺/血浆总蛋白在糖尿病诊断中的价值比较[J].国际检验医学杂志,2017,38(16):2288-2290. CHEN Lixin,ZHANG Jingyu,WANG Lifang,et al.Comparison of the value of fructosamine to albumin ratio and fructosamine to total protein ratio in the diagnosis of diabetes mellitus[J].Int J Lab Med,2017,38(16):2288-2290.
[6] 张丽红,黄婷婷.果糖胺/血清蛋白比值对糖尿病的诊断价值[J].中国糖尿病杂志,2015,23(10):912-914. ZHANG Lihong,HUANG Tingting.The value of fructosamine/serum protein ratio in diagnosis of diabetes mellitus[J].Chinese Journal of Diabetes,2015,23(10):912-914.
[7] 中华人民共和国国家卫生和计划生育委员会.WS/T402-2012:临床实验室检验项目参考区间的制定[S].北京:中国标准出版社,2013. Ministry Health and Family Planning Commission of the People’s Republic of China.WS/T402-2012:Define and determine the reference intervals in clinical laboratory[S].Beijing:China Standard Press,2013.
[8] 高原,杨剑敏,王欢,等.上海市区2 408例健康儿童末梢血血常规参数的参考区间调查分析[J].检验医学,2012,27(3):217-220. GAO Yuan,YANG Jianmin,WANG Huan,et al.Survey analysis on the routine reference intervals of peripheral blood determination among 2 408 healthy children in Shanghai[J].Laboratory Medicine,2012,27(3):217-220.
[9] 章晓燕,王薇,何法霖,等.全国网织红细胞计数参考区间和决定限现状调查与分析[J].现代检验医学杂志,2016,31(3):158-161.ZHANG Xiaoyan,WANG Wei,HE Falin,et al.Investigation and analysis of reference intervals and decision limits of reticulocyte count in China[J].J Mod Lab Med,2016,31(3):158-161.
[10] 段敏,赵海建,王薇,等.临床检验参考区间和决定限的质量要求[J].现代检验医学杂志,2017,32(5):148-151. DUAN Min,ZHAO Haijian,WANG Wei,et al.Quality requirements for reference intervals and decision limits in clinical laboratory[J].J Mod Lab Med,2017,32(5):148-151.