KHẢO SÁT MỘT SỐ CHỈ SỐ GLYCAT HÓA PROTEIN VÀ XÉT NGHIỆM ĐÁNH GIÁ CHỨC NĂNG THẬN Ở BỆNH NHÂN ĐÁI THÁO ĐƯỜNG TYPE 2 ĐƯỢC CHẨN ĐOÁN LẦN ĐẦU

Abstract

Background: Hyperglycemia in diabetes mellitus (DM) is always associated with increased glycation of free amino radicals on body proteins. Therefore, protein glycation indices are important in monitoring glycemic control. Renal dysfunction is an early and common manifestation in patients with type 2 DM. This study was conducted with the aim of examining some protein glycation indices and renal function tests in patients with type 2 diabetes mellitus (DM) diagnosed for the first time. Methods: The study design was a cross-sectional, analytical study conducted on 103 patients with first-time diagnosis of type 2 diabetes from September 2024 to June 2025. HbA1c was measured by high-performance liquid chromatography (HPLC). Fasting plasma glucose, plasma fructosamine, plasma creatinine, plasma cystatin C, urinary creatinine, and microalbuminuria (MAU) were quantified by photometry. Glycation gap (GG), hemoglobin glycation index (HGI), urinary albumin/creatinine ratio (uACR), and estimated glomerular filtration rate (eGFR) were calculated based on established formulas. Results: The mean HbA1c concentration was 9.53 ± 2.38%, with 50.5% of patients having HbA1c > 9%. The mean fructosamine concentration was 468.31 ± 137.16 µmol/L; 59.2% of patients had fructosamine ≥ 400 µmol/L. The median GG value was -0.02% (-0.75 to 0.98), with 24.3% of patients having GG > 1%. The median HGI index was 1.34% (0.65 – 2.34), with 90.3% of patients having HGI > 0.15%. HbA1c was strongly positively correlated with fructosamine concentration (r=0.78), moderately with HGI (r=0.70), moderately with GG (r=0.43); with p < 0.001. Regarding renal function, the median ACR was 1.98 mg/mmol; 2.91% of patients had high albuminuria (A3), 32.04% had moderate (A2) and 65.05% were normal (A1). The median eGFR value was 100.7 ± 20.8 mL/min/1.73m²; 4.9% of patients had eGFR < 60 mL/min/1.73m². Conclusions: In patients with type 2 diabetes diagnosed for the first time, the Fructosamine, GG, and HGI indices were positively correlated at a strong and moderate level; early kidney damage occurred in 34.95% of patients [2.91% had high MAU (A3), 32.04% had moderate MAU (A2)]; 4.9% of patients had reduced glomerular filtration rate (eGFR<60 mL/phút/1,73m²).