Recent Developments in the Diagnosis of Hepatogenous Diabetes

doi:10.12114/j.issn.1007-9572.2021.00.068

Abstract

Abstract: Hepatogenous diabetes（HD）can be defined as a kind of glucose metabolic disorders secondary to impaired liver functions caused by liver cirrhosis，the final stage of chronic liver disease associated with progressive liver fibrosis. HD may increase the risk of common complications of liver cirrhosis，such as hepatic encephalopathy，upper gastrointestinal bleeding，spontaneous peritonitis，ascites and infection，as well as the risk of progression from cirrhosis to liver cancer and the mortality of liver cancer. As glycemic control is an effective means to improve the prognosis of HD，early identifying and intervening HD are of great clinical significance. At present，it is still difficult to make a clinical diagnosis of HD，and there are no systematic diagnostic strategies for HD in China. In this paper，we reviewed the recent developments in HD diagnosis，with a view to helping early clinical identification of HD to improve the prognosis of patients with liver cirrhosis.

Key words: Liver cirrhosis, Diabetes mellitus, Hepatogenous diabetes, Impaired glucose tolerance, Insulin resistance, Glucose tolerance test, Diagnosis, Review

摘要： 肝硬化是与进行性肝纤维化相关的慢性肝病的最后阶段，而继发于肝硬化的糖代谢紊乱被称为肝源性糖尿病（HD）。HD不仅会增加肝性脑病、上消化道出血、自发性腹膜炎、腹腔积液及感染等肝硬化常见并发症发生率，还会增加肝硬化进展为肝癌的风险及肝癌患者死亡率。由于控制血糖可有效改善HD患者预后，因此HD的早期识别及干预具有重要临床意义。目前，HD的临床诊断较困难，国内亦未系统地提出HD的诊断策略。本文对近年来关于HD诊断的研究进展进行了综述，以期帮助临床早期识别HD，减少肝硬化患者不良预后。

关键词: 肝硬化, 糖尿病, 肝源性糖尿病, 糖耐量受损, 胰岛素抵抗, 葡糖耐量实验, 诊断, 综述

TIAN Caiyun,HU Han,ZHANG Guoyuan, et al. Recent Developments in the Diagnosis of Hepatogenous Diabetes　[J]. Chinese General Practice, 2021, 24(9): 1158-1164. DOI: 10.12114/j.issn.1007-9572.2021.00.068.
田彩云,胡晗,张国远等. 肝源性糖尿病的诊断研究进展[J]. 中国全科医学, 2021, 24(9): 1158-1164. DOI: 10.12114/j.issn.1007-9572.2021.00.068.

References

［1］NCD Risk Factor Collaboration（NCD-RisC）.Worldwide trends in diabetes since 1980：a pooled analysis of 751 population-based studies with 4.4 million participants［J］.Lancet，2016，387（10027）：1513-1530.DOI：10.1016/S0140-6736（16）00618-8.
［2］GBD 2015 Mortality and Causes of Death Collaborators.Global，regional，and national life expectancy，all-cause mortality，and cause-specific mortality for 249 causes of death，1980—2015：a systematic analysis for the Global Burden of Disease Study 2015［J］.Lancet，2016，388（10053）：1459-1544.DOI：10.1016/S0140-6736（16）31012-1.
［3］MOKDAD A A，LOPEZ A D，SHAHRAZ S，et al．Liver cirrhosis mortality in 187 countries between 1980 and 2010：a systematic analysis［J］.BMC Med，2014，12：145.DOI：10.1186/s12916-014-0145-y.
［4］BECHMANN L P，HANNIVOORT R A，GERKEN G，et al．The interaction of hepatic lipid and glucose metabolism in liver diseases［J］.J Hepatol，2012，56（4）：952-964.DOI：10.1016/j.jhep.2011.08.025.
［5］GARCIA-COMPEAN D，JAQUEZ-QUINTANA J O，GONZALEZ-GONZALEZ J A，et al．Liver cirrhosis and diabetes：risk factors，pathophysiology，clinical implications and management［J］.World J Gastroenterol，2009，15（3）：280-288.DOI：10.3748/wjg.15.280.
［6］HSIEH P S，HSIEH Y J.Impact of liver diseases on the development of type 2 diabetes mellitus［J］.World J Gastroenterol，2011，17（48）：5240-5245.DOI：10.3748/wjg.v17.i48.5240.
［7］HUANG Y W，YANG S S，FU S C，et al．Increased risk of cirrhosis and its decompensation in chronic hepatitis C patients with new-onset diabetes：a nationwide cohort study［J］.Hepatology，2014，60（3）：807-814.DOI：10.1002/hep.27212.
［8］HUANG Y W，WANG T C，LIN S C，et al．Increased risk of cirrhosis and its decompensation in chronic hepatitis B patients with newly diagnosed diabetes：a nationwide cohort study［J］.Clin Infect Dis，2013，57（12）：1695-1702.DOI：10.1093/cid/cit603.
［9］LI X，GAO Y，XU H，et al．Diabetes mellitus is a significant risk factor for the development of liver cirrhosis in chronic hepatitis C patients［J］.Sci Rep，2017，7（1）：9087.DOI：10.1038/s41598-017-09825-7.
［10］MAKOL A，KANTHAJE S，DHIMAN R K，et al．Association of liver cirrhosis severity with type 2 diabetes mellitus in hepatocellular carcinoma［J］.Exp Biol Med（Maywood），2018，243（4）：323-326.DOI：10.1177/1535370217744511.
［11］DESBOIS A C，CACOUB P.Diabetes mellitus，insulin resistance and hepatitis C virus infection：a contemporary review［J］.World J Gastroenterol，2017，23（9）：1697-1711.DOI：10.3748/wjg.v23.i9.1697.
［12］JEPSEN P，WATSON H，ANDERSEN P K，et al．Diabetes as a risk factor for hepatic encephalopathy in cirrhosis patients［J］.J Hepatol，2015，63（5）：1133-1138.DOI：10.1016/j.jhep.2015.07.007.
［13］BUTT Z，JADOON N A，SALARIA O N，et al．Diabetes mellitus and decompensated cirrhosis：risk of hepatic encephalopathy in different age groups［J］.J Diabetes，2013，5（4）：449-455.DOI：10.1111/1753-0407.12067.
［14］QI X，PENG Y，LI H，et al．Diabetes is associated with an increased risk of in-hospital mortality in liver cirrhosis with acute upper gastrointestinal bleeding［J］.Eur J Gastroenterol Hepatol，2015，27（4）：476-477.DOI：10.1097/MEG.0000000000000324.
［15］JEON H K，KIM M Y，BAIK S K，et al．Hepatogenous diabetes in cirrhosis is related to portal pressure and variceal hemorrhage［J］.Dig Dis Sci，2013，58（11）：3335-3341.DOI：10.1007/s10620-013-2802-y.
［16］WLAZLO N，VAN GREEVENBROEK M M，CURVERS J，et al．Diabetes mellitus at the time of diagnosis of cirrhosis is associated with higher incidence of spontaneous bacterial peritonitis，but not with increased mortality［J］.Clin Sci（Lond），2013，125（7）：341-348.DOI：10.1042/CS20120596.
［17］MOREAU R，DELèGUE P，PESSIONE F，et al．Clinical characteristics and outcome of patients with cirrhosis and refractory ascites［J］.Liver Int，2004，24（5）：457-464.DOI：10.1111/j.1478-3231.2004.0991.x.
［18］GOH G B B，PAN A，CHOW W C，et al．Association between diabetes mellitus and cirrhosis mortality：the Singapore Chinese Health Study［J］.Liver Int，2017，37（2）：251-258.DOI：10.1111/liv.13241.
［19］EL-SERAG H B，TRAN T，EVERHART J E.Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma［J］.Gastroenterology，2004，126（2）：460-468.DOI：10.1053/j.gastro.2003.10.065.
［20］LIEBER S R，LEE R A，JIANG Y，et al．The impact of post-transplant diabetes mellitus on liver transplant outcomes［J］.Clin Transplant，2019，33（6）：e13554.DOI：10.1111/ctr.13554.
［21］NISHIDA T，TSUJI S，TSUJII M，et al．Oral glucose tolerance test predicts prognosis of patients with liver cirrhosis［J］.Am J Gastroenterol，2006，101（1）：70-75.DOI：10.1111/j.1572-0241.2005.00307.x.
［22］GARCíA-COMPEáN D，JáQUEZ-QUINTANA J O，LAVALLE-GONZáLEZ F J，et al．Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis［J］.World J Gastroenterol，2014，20（22）：7011-7018.DOI：10.3748/wjg.v20.i22.7011.
［23］ELKRIEF L，CHOUINARD P，BENDERSKY N，et al．Diabetes mellitus is an independent prognostic factor for major liver-related outcomes in patients with cirrhosis and chronic hepatitis C［J］.Hepatology，2014，60（3）：823-831.DOI：10.1002/hep.27228.
［24］GRANCINI V，TROMBETTA M，LUNATI M E，et al．Central role of the β-cell in driving regression of diabetes after liver transplantation in cirrhotic patients［J］.J Hepatol，2019，70（5）：954-962.DOI：10.1016/j.jhep.2019.01.015.
［25］RAMOS-PROL A，HERVáS-MARíN D，RODRíGUEZ-MEDINA B，et al．Alterations in carbohydrate metabolism in cirrhotic patients before and after liver transplant［J］.Diabetes Res Clin Pract，2015，110（2）：123-128.DOI：10.1016/j.diabres.2015.10.002.
［26］SALOMONE F，CATANIA M，MONTINERI A，et al．Hepatitis C virus eradication by direct antiviral agents improves glucose tolerance and reduces post-load insulin resistance in nondiabetic patients with genotype 1［J］.Liver Int，2018，38（7）：1206-1211.DOI：10.1111/liv.13669.
［27］ORSI E，GRANCINI V，MENINI S，et al．Hepatogenous diabetes：is it time to separate it from type 2 diabetes？［J］.Liver Int，2017，37（7）：950-962.DOI：10.1111/liv.13337.
［28］GRANCINI V，TROMBETTA M，LUNATI M E，et al．Contribution of β-cell dysfunction and insulin resistance to cirrhosis-associated diabetes：role of severity of liver disease［J］.J Hepatol，2015，63（6）：1484-1490.DOI：10.1016/j.jhep.2015.08.011.
［29］KIM M G，CHOI W C.Differential diagnosis of diabetes mellitus caused by liver cirrhosis and other type 2 diabetes mellitus［J］.Korean J Hepatol，2006，12（4）：524-529.
［30］HOLSTEIN A，HINZE S，THIESSEN E，et al．Clinical implications of hepatogenous diabetes in liver cirrhosis［J］.J Gastroenterol Hepatol，2002，17（6）：677-681.DOI：10.1046/j.1440-1746.2002.02755.x.
［31］HONDA F，HIRAMATSU A，HYOGO H，et al．Evaluation of glycemic variability in chronic liver disease patients with type 2 diabetes mellitus using continuous glucose monitoring［J］.PloS one，2018，13（4）：e0195028.DOI：10.1371/journal.pone.0195028.
［32］PETIT J M，HAMZA S，ROLLOT F，et al．Impact of liver disease severity and etiology on the occurrence of diabetes mellitus in patients with liver cirrhosis［J］.Acta Diabetol，2014，51（3）：455-460.DOI：10.1007/s00592-013-0538-y.
［33］HICKMAN I J，MACDONALD G A.Impact of diabetes on the severity of liver disease［J］.Am J Med，2007，120（10）：829-834.DOI：10.1016/j.amjmed.2007.03.025.
［34］PICARDI A，D'AVOLA D，GENTILUCCI U V，et al．Diabetes in chronic liver disease：from old concepts to new evidence［J］.Diabetes Metab Res Rev，2006，22（4）：274-283.DOI：10.1002/dmrr.636.
［35］DHAHBI J M，MOTE P L，CAO S X，et al．Hepatic gene expression profiling of streptozotocin-induced diabetes［J］.Diabetes Technol Ther，2003，5（3）：411-420.DOI：10.1089/152091503765691910.
［36］KAWAGUCHI T，TANIGUCHI E，ITOU M，et al．Insulin resistance and chronic liver disease［J］.World J Hepatol，2011，3（5）：99-107.DOI：10.4254/wjh.v3.i5.99.
［37］SHANIK M，XU Y，SKRHA J，et al．Insulin resistance and hyperinsulinemia：is hyperinsulinemia the cart or the horse？［J］.Diabetes care，2008，33（Suppl 2）：S262-268.DOI：10.2337/dc08-s264.
［38］ELKRIEF L，RAUTOU P E，SARIN S，et al．Diabetes mellitus in patients with cirrhosis：clinical implications and management［J］.Liver Int，2016，36（7）：936-948.DOI：10.1111/liv.13115.
［39］AYTUG S，REICH D，SAPIRO L E，et al．Impaired IRS-1/PI3-kinase signaling in patients with HCV：a mechanism for increased prevalence of type 2 diabetes［J］.Hepatology，2003，38（6）：1384-1392.DOI：10.1016/j.hep.2003.09.012.
［40］American Diabetes Association.（2）Classification and diagnosis of diabetes［J］.Diabetes Care，2015，38 Suppl：S8-16.DOI：10.2337/dc15-S005.
［41］GARCíA-COMPEáN D，JáQUEZ-QUINTANA J O，LAVALLE-GONZáLEZ F J，et al．The prevalence and clinical characteristics of glucose metabolism disorders in patients with liver cirrhosis.A prospective study［J］.Ann Hepatol，2012，11（2）：240-248.
［42］ELKRIEF L，RAUTOU P E，SARIN S，et al．Diabetes mellitus in patients with cirrhosis：clinical implications and management［J］.Liver Int，2016，36（7）：936-948.DOI：10.1111/liv.13115.
［43］HAMED A E，ELSAHAR E，ELWAN N M，et al．Managing diabetes and liver disease association［J］.Arab J Gastroenterol，2018，19（ 4）：166-179.DOI：10.1016/j.ajg.2018.08.003.
［44］PAPATHEODORIDIS G V，CHRYSANTHOS N，SAVVAS S，et al．Diabetes mellitus in chronic hepatitis B and C：prevalence and potential association with the extent of liver fibrosis［J］.J Viral Hepat，2006，13（5）：303-310.DOI：10.1111/j.1365-2893.2005.00677.x.
［45］LAHOUSEN T，HEGENBARTH K，ILLE R，et al．Determination of glycated hemoglobin in patients with advanced liver disease［J］.World J Gastroenterol，2004，10（15）：2284-2286.DOI：10.3748/wjg.v10.i15.2284.
［46］KUMAR R.Hepatogenous diabetes：an underestimated problem of liver cirrhosis［J］.Indian J Endocrinol Metab，2018，22（4）：552-559.DOI：10.4103/ijem.IJEM_79_18.
［47］American Diabetes Association.Standards of medical care in diabetes——2010［J］.Diabetes Care，2010，33（Suppl 1）：S11-61.DOI：10.2337/dc10-S011.
［48］NATHAN D M，BALKAU B，BONORA E，et al．International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes［J］.Diabetes Care，2009，32（7）：1327-1334.DOI：10.2337/dc09-9033.
［49］IMANO E，KANDA T，NAKATANI Y，et al．Impaired splanchnic and peripheral glucose uptake in liver cirrhosis［J］.J Hepatol，1999，31（3）：469-473.DOI：10.1016/s0168-8278（99）80039-7.
［50］SHMUELI E，WALKER M，ALBERTI G，et al．Normal splanchnic but impaired peripheral insulin-stimulated glucose uptake in cirrhosis［J］.Hepatology，1993，18（1）：86-95.DOI：10.1002/hep.1840180115.
［51］GARCíA-COMPEáN D，JáQUEZ-QUINTANA J O，GONZáLEZ-GONZáLEZ J A，et al．Diabetes in liver cirrhosis［J］.Gastroenterol Hepatol，2013，36（7）：473-482.DOI：10.1016/j.gastrohep.2013.01.012.
［52］IMANO E，NISHIDA T，SHIBATA M，et al．Significance of oral glucose tolerance test for the diagnosis of diabetes mellitus in patients with liver cirrhosis［J］.Intern Med，1999，38（11）：918.DOI：10.2169/internalmedicine.38.918.
［53］NISHIDA T.Diagnosis and clinical implications of diabetes in liver cirrhosis：a focus on the oral glucose tolerance test［J］.J Endocr Soc，2017，1（7）：886-896.DOI：10.1210/js.2017-00183.
［54］LENTERS-WESTRA E，SCHINDHELM R K，BILO H J，et al．Haemoglobin A1c：historical overview and current concepts［J］.Diabetes Res Clin Pract，2013，99（2）：75-84.DOI：10.1016/j.diabres.2012.10.007.
［55］BUNN H F，HANEY D N，KAMIN S，et al．The biosynthesis of human hemoglobin A1c.Slow glycosylation of hemoglobin in vivo［J］.J Clin Invest，1976，57（6）：1652-1659.DOI：10.1172/JCI108436.
［56］MARSHALL S M.Standardization of HbA1c：good or bad？［J］.Nat Rev Endocrinol，2010，6（7）：408-411.DOI：10.1038/nrendo.2010.66.
［57］American Diabetes Association.Standards of medical care for patients with diabetes mellitus［J］.Diabetes Care，2003，26（Suppl 1）：S33-50.DOI：10.2337/diacare.26.2007.s33.
［58］Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes（UKPDS 33）.UK Prospective Diabetes Study（UKPDS）Group［J］.Lancet，1998，352（9131）：837-853.
［59］HAMED A E，ELWAN N，NAGUIB M，et al．Diabetes association with liver diseases：an overview for clinicians［J］.Endocr Metab Immune Disord Drug Targets，2019，19（3）：274-280.DOI：10.2174/1871530318666181116111945.
［60］ENGLISH E，IDRIS I，SMITH G，et al．The effect of anaemia and abnormalities of erythrocyte indices on HbA1c analysis：a systematic review［J］.Diabetologia，2015，58（7）：1409-1421.DOI：10.1007/s00125-015-3599-3.
［61］RADIN M S.Pitfalls in hemoglobin A1c measurement：when results may be misleading［J］.J Gen Intern Med，2014，29（2）：388-394.DOI：10.1007/s11606-013-2595-x.
［62］FREEDMAN B I，SHENOY R N，PLANER J A，et al．Comparison of glycated albumin and hemoglobin A1c concentrations in diabetic subjects on peritoneal and hemodialysis［J］.Perit Dial Int，2010，30（1）：72-79.DOI：10.3747/pdi.2008.00243.
［63］FALKO J M，O'DORISIO T M，CATALAND S.Spurious elevations in glycosylated hemoglobin（HbA1c）secondary to hypertriglyceridemia［J］.Arch Intern Med，1982，142（7）：1370-1371.DOI：10.1001/archinte.142.7.1370.
［64］HOMA K，MAJKOWSKA L.Difficulties in interpreting HbA（1c）results［J］.Pol Arch Med Wewn，2010，120（4）：148-154.
［65］KOGA M，KASAYAMA S，KANEHARA H，et al．CLD（chronic liver diseases）-HbA1c as a suitable indicator for estimation of mean plasma glucose in patients with chronic liver diseases［J］.Diabetes Res Clin Pract，2008，81（2）：258-262.DOI：10.1016/j.diabres.2008.04.012.
［66］NOMURA Y，NANJO K，MIYANO M，et al．Hemoglobin A1 in cirrhosis of the liver［J］.Diabetes Res，1989，11（4）：177-180.DOI：10.2337/diabetes.38.8.1072.
［67］SEHRAWAT T，JINDAL A，KOHLI P，et al．Utility and limitations of glycated hemoglobin（HbA1c）in patients with liver cirrhosis as compared with oral glucose tolerance test for diagnosis of diabetes［J］.Diabetes Ther，2018，9（1）：243-251.DOI：10.1007/s13300-017-0362-4.
［68］MORSE E E.Mechanisms of hemolysis in liver disease［J］.Ann Clin Lab Sci，1990，20（3）：169-174.
［69］GONZALEZ-CASAS R，JONES E A，MORENO-OTERO R.Spectrum of anemia associated with chronic liver disease［J］.World J Gastroenterol，2009，15（37）：4653-4658.DOI：10.3748/wjg.15.4653.
［70］NADELSON J，SATAPATHY S K，NAIR S.Glycated hemoglobin levels in patients with decompensated cirrhosis［J］.Int J Endocrinol，2016，2016：8390210.DOI：10.1155/2016/8390210.
［71］TAKAHASHI S，UCHINO H，SHIMIZU T，et al．Comparison of glycated albumin（GA）and glycated hemoglobin（HbA1c）in type 2 diabetic patients：usefulness of GA for evaluation of short-term changes in glycemic control［J］.Endocr J，2007，54（1）：139-144.DOI：10.1507/endocrj.k06-103.
［72］FURUSYO N，KOGA T，AI M，et al．Utility of glycated albumin for the diagnosis of diabetes mellitus in a Japanese population study：results from the Kyushu and Okinawa Population Study（KOPS）［J］.Diabetologia，2011，54（12）：3028-3036.DOI：10.1007/s00125-011-2310-6.
［73］IKEZAKI H，FURUSYO N，IHARA T，et al．Glycated albumin as a diagnostic tool for diabetes in a general Japanese population［J］.Metabolism，2015，64（6）：698-705.DOI：10.1016/j.metabol.2015.03.003.
［74］TAHARA Y，SHIMA K.Kinetics of HbA1c，glycated albumin，and fructosamine and analysis of their weight functions against preceding plasma glucose level［J］.Diabetes Care，1995，18（4）：440-447.DOI：10.2337/diacare.18.4.440.
［75］SUWA T，OHTA A，MATSUI T，et al．Relationship between clinical markers of glycemia and glucose excursion evaluated by continuous glucose monitoring（CGM）［J］.Endocr J，2010，57（2）：135-140.DOI：10.1507/endocrj.k09e-234.
［76］KOGA M.Glycated albumin；clinical usefulness［J］.Clin Chim Acta，2014，433：96-104.DOI：10.1016/j.cca.2014.03.001.
［77］LEE J E.Alternative biomarkers for assessing glycemic control in diabetes：fructosamine，glycated albumin，and 1，5-anhydroglucitol［J］.Ann Pediatr Endocrinol Metab，2015，20（2）：74-78.DOI：10.6065/apem.2015.20.2.74.
［78］DOZIO E，DI GAETANO N，FINDEISEN P，et al．Glycated albumin：from biochemistry and laboratory medicine to clinical practice［J］.Endocrine，2017，55（3）：682-690.DOI：10.1007/s12020-016-1091-6.
［79］ISODA H，TAKAHASHI H，EGUCHI Y，et al．Re-evaluation of glycated hemoglobin and glycated albumin with continuous glucose monitoring system as markers of glycemia in patients with liver cirrhosis［J］.Biomed Rep，2017，7（3）：286.DOI：10.3892/br.2017.928.
［80］GOLDSTEIN D E，LITTLE R R，LORENZ R A，et al．Tests of glycemia in diabetes［J］.Diabetes Care，2004，27（7）：1761-1773.DOI：10.2337/diacare.27.7.1761.
［81］DANESE E，MONTAGNANA M，NOUVENNE A，et al．Advantages and pitfalls of fructosamine and glycated albumin in the diagnosis and treatment of diabetes［J］.J Diabetes Sci Technol，2015，9（2）：169-176.DOI：10.1177/1932296814567227.
［82］TRENTI T，CRISTANI A，CIONI G，et al．Fructosamine and glycated hemoglobin as indices of glycemic control in patients with liver cirrhosis［J］.Ric Clin Lab，1990，20（4）：261-267.DOI：10.1007/BF02900711.
［83］RODRIGUEZ-SEGADE S，LOJO S，CAMI?A M F，et al．Effects of various serum proteins on quantification of fructosamine［J］.Clin Chem，1989，35（1）：134-138.
［84］SEOK H，HUH J H，KIM H M，et al．1，5-anhydroglucitol as a useful marker for assessing short-term glycemic excursions in type 1 diabetes［J］.Diabetes Metab J，2015，39（2）：164-170.DOI：10.4093/dmj.2015.39.2.164.
［85］KOGA M.1，5-anhydroglucitol and glycated albumin in glycemia［J］.Adv Clin Chem，2014，64：269-301.DOI：10.1016/b978-0-12-800263-6.00007-0.
［86］DUNGAN K M，BUSE J B，LARGAY J，et al．1，5-anhydroglucitol and postprandial hyperglycemia as measured by continuous glucose monitoring system in moderately controlled patients with diabetes［J］.Diabetes Care，2006，29（6）：1214-1219.DOI：10.2337/dc06-1910.
［87］MCGILL J B，COLE T G，NOWATZKE W，et al．Circulating 1，5-anhydroglucitol levels in adult patients with diabetes reflect longitudinal changes of glycemia：a U.S.trial of the GlycoMark assay［J］.Diabetes Care，2004，27（8）：1859-1865.DOI：10.2337/diacare.27.8.1859.
［88］BECK R，STEFFES M，XING D，et al．The interrelationships of glycemic control measures：HbA1c，glycated albumin，fructosamine，1，5-anhydroglucitrol，and continuous glucose monitoring［J］.Pediatr Diabetes，2011，12（8）：690-695.DOI：10.1111/j.1399-5448.2011.00764.x.
［89］YAMAGISHI S，OHTA M.Serum 1，5-anhydro-D-glucitol levels in liver cirrhosis［J］.Acta Diabetol，1998，35（1）：65-66.DOI：10.1007/s005920050104.

[1]	LI Jiawei, GAO Xinyi, GE Aoqi, LI Juanjuan, YUAN Beibei. Demand and Associated Factors for Integrated Medical Care and Preventive Services among Patients with Type 2 Diabetes [J]. Chinese General Practice, 2026, 29(21): 3028-3039.
[2]	LI Wenping, CHEN Jianhua, XU Jiapei, JIN Xue, PAN Zihan, CHI Chunhua. A Scoping Review on the Empowerment of Community Elderly Health Services by Digital-Intelligent Health Management Platforms [J]. Chinese General Practice, 2026, 29(21): 2938-2949.
[3]	FENG Yuxi, WANG Jinjin, CAI Yi, ZHU Runzhi, ZHU Qin. Research Progress on Protein Lactylation in Kidney Diseases [J]. Chinese General Practice, 2026, 29(21): 3056-3063.
[4]	WANG Yang, ZHAO Shiting, CHEN Yingying, SUN Zilin, QIU Shanhu. Key Points of Exercise Intervention and Implementation for People with Complications of Type 2 Diabetes Mellitus [J]. Chinese General Practice, 2026, 29(21): 2989-2994.
[5]	AN Yanhong, WANG Shidong, LI Xiaoran, GUO Jiayang, WANG Zhe, SHA Peilin, MENG Yijun, LI Xiaoxuan, SHI Xue, YU Zexing, XIAO Yonghua. Study on Risk Factors and Nomogram Prediction Model for Diabetic Kidney Disease: Based on Contrast-enhanced Ultrasound Technology [J]. Chinese General Practice, 2026, 29(21): 2995-3003.
[6]	PAN Ziyun, YIN Hao, LIN Zhirou, MAO Jingyi, HUANG Yan, LUO Yanhua, XIAO Jiafu, HU Yin. From Mechanism to Therapy: Diabetic Autonomic Neuropathy [J]. Chinese General Practice, 2026, 29(21): 2982-2988.
[7]	GE Dan, WANG Zhi, DING Qun, GUO Tonglan, XU Tongdao. Relationship between Remnant Cholesterol and Non-alcoholic Fatty Liver Disease as well as Progressive Liver Fibrosis in Patients with Type 2 Diabetes Mellitus [J]. Chinese General Practice, 2026, 29(20): 2854-2859.
[8]	YAN Wen, ZHANG Hanzhi, JIN Hua, QIAN Jie, YU Dehua. Study on the Diagnosis and Treatment Capacity for Depressive Disorders in Community Health Service Institutions in Shanghai [J]. Chinese General Practice, 2026, 29(20): 2790-2799.
[9]	CHENG Yu, HAN Shiyao, SUN Ping, XIANG Juan, YANG Hui, LI Dongze, ZHENG Li, LIAO Xiaoyang. Analysis of Socioeconomic and Demographic Challenges in Chronic Disease Management [J]. Chinese General Practice, 2026, 29(20): 2800-2807.
[10]	ZHANG Xiaojuan, LIU Yang, PENG Bo, YE Yuan, ZHU Kun. Study on the Prevention and Treatment of Hypertension and Diabetes Mellitus in Community Hospital [J]. Chinese General Practice, 2026, 29(19): 2614-2620.
[11]	JIAN Yingchun, ZENG Yongqin, ZHANG Haiping, WANG Zhengdi, AN Ke, YAN Rui. Recent Advances in Mitochondrial Dysfunction in Chronic Metabolic Diseases [J]. Chinese General Practice, 2026, 29(18): 2577-2584.
[12]	ZHANG Mingyue, HOU Yan. Research Progress of Exhaled Nitric Oxide and Alveolar Nitric Oxide in Interstitial Lung Diseases [J]. Chinese General Practice, 2026, 29(18): 2571-2576.
[13]	FAN Meixiang, YAN Yunyun, HUANG Yanyan. Interpretation and Discussion of Guidelines for Preventive Activities in General Practice: Bladder Cancer [J]. Chinese General Practice, 2026, 29(18): 2450-2453.
[14]	LI Yachan, YANG Yang, XU Qianting, KE Tingyu. Association between the Chinese Visceral Adiposity Index and Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus [J]. Chinese General Practice, 2026, 29(18): 2482-2488.
[15]	CHEN Yiping, ZHANG Jianmei, LI Yanhu, LI Rui, ZHANG Ruiping, YANG Ping. Advances in the Diagnosis and Treatment of Post-COVID-19 Condition of Myocardial Injury [J]. Chinese General Practice, 2026, 29(18): 2585-2592.