摘要目的:探讨1型糖尿病人群中糖化白蛋白/HbA 1C比值与血糖波动幅度的相关性及基线糖化白蛋白/HbA 1C比值与长期血糖控制的相关性。 方法:2013年至2014年于复旦大学附属中山医院首诊的1型糖尿病住院患者共110例入选。收集其一般临床资料，包括基线空腹C肽、激发后C肽(精氨酸试验)，基线及2017年至2018年期间随访时HbA 1C、糖化白蛋白(GA)、空腹血糖等，采集每例患者胰岛素皮下注射1周后3日的每日7次指尖血糖(包括三餐前、三餐后2 h及睡前)值，并以此计算平均血糖、平均血糖波动幅度(MAGE)、最高及最低血糖差在内的血糖波动指数。采用SPSS 13.0统计学软件进行数据统计分析。 结果:110例1型糖尿病患者以基线GA/HbA 1C比值三分位数分组，随着基线GA/HbA 1C比值升高，基线空腹C肽和激发后C肽值呈逐渐降低趋势( P趋势<0.05)，基线MAGE、随访时HbA 1C和空腹血糖呈逐步升高趋势( P趋势<0.05)。 Pearson相关分析显示，基线GA/HbA 1C比值与基线空腹C肽和激发后C肽水平呈负相关( P<0.01)，与基线MAGE及随访时HbA 1C和空腹血糖呈正相关( P<0.05)。多元线性逐步回归分析显示，基线GA/HbA 1C比值与基线MAGE和激发后C肽水平、随访时空腹血糖和HbA 1C独立相关( P<0.05)。多因素 COX回归分析显示，基线GA/HbA 1C比值大于2.85是随访时空腹血糖( OR＝3.028，95% CI 1.291～7.101)、HbA 1C( OR＝3.038，95% CI 1.416～6.515)不达标的独立危险因素。 结论:1型糖尿病患者基线GA/HbA 1C与血糖波动幅度切相关，与随访后的空腹血糖和HbA 1C独立相关，基线GA/HbA 1C比值大于2.85是空腹血糖及HbA 1C不达标的独立危险因素。

abstractsObjective:The relationships between glycated albumin(GA) to HbA 1C ratio and the blood glucose variability, and the correlations between baseline GA to HbA 1C ratio and long-term glycemic control in type 1 diabetic patients were investigated. Methods:One hundred and ten patients with new-onset type 1 diabetes from Zhongshan Hospital, Fudan University were recruited during 2013-2014. Relevant clinical data, including fasting and stimulated C-peptide(arginine stimulation test) at baseline, HbA 1C, GA, fasting blood glucose at baseline and follow-up during 2017-2018 were collected. Capillary glucose values of each patient were recorded 7 times daily(preprandial and 120 minutes postprandial for each meal and bedtime)for 3 days after 1 week of subcutaneous injection of insulin. The blood glucose fluctuation indexes, including mean blood glucose, mean amplitude of glucose excursions(MAGE), △blood glucose were calculated. The software SPSS 13.0 was used for the statistical analysis. Results:One hundred and ten patients with type 1 diabetes were grouped by baseline GA/HbA 1C ratio tertiles. With the increasing of GA/HbA 1C at baseline, the fasting and stimulated C-peptide at baseline were gradually decreased( Ptrend<0.05); MAGE at baseline, HbA 1C and fasting blood glucose after follow-up increased gradually( Ptrend<0.05). Pearson correlation analysis showed that the baseline GA/HbA 1C ratio was negatively correlated with fasting and stimulated C-peptide at baseline( P<0.01), and positively correlated with MAGE at baseline, HbA 1C and fasting blood glucose after follow-up( P<0.05). Stepwise multivariate analysis suggested that the baseline GA/HbA 1C ratio was independently associated with MAGE and stimulated C-peptide at baseline, fasting blood glucose and HbA 1C after follow-up( P<0.05). Multivariate COX regression analysis showed that baseline GA/HbA 1C ratio greater than 2.85 acted as an independent risk factor for un-controlled fasting blood glucose( OR=3.028, 95% CI 1.291-7.101)and HbA 1C( OR=3.038, 95% CI 1.416-6.515) after follow-up. Conclusion:Baseline GA/HbA 1C was closely associated with glucose excursion in type 1 diabetes patients, and was independently associated with fasting blood glucose and HbA 1C after follow-up. Baseline GA/HbA 1C ratio greater than 2.85 was an independent risk factor for un-controlled fasting blood glucose, as well as HbA 1C.