Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
Clin Endocrinol (Oxf). 2011 Dec;75(6):780-5. doi: 10.1111/j.1365-2265.2011.04129.x.
The association between haemoglobin A1c (HbA1c) levels and subclinical atherosclerosis in carotid arteries in Chinese populations is unknown. AIM, DESIGN AND METHODS: The objective of this study was to investigate this relationship and evaluate the ability of HbA1c levels to predict carotid atherosclerosis in a Chinese population. This was a cross-sectional study, which included 541 subjects without known diabetes (Taiwan Lifestyle Study). About 67 (9·2%) subjects were newly diagnosed with diabetes during the study. Carotid intima-media thickness (IMT) and the presence of carotid plaques were determined using ultrasonography.
The HbA1c level in all subjects was positively correlated with carotid IMT (β = 0·018, P = 0·03) after being adjusted for age, gender, smoking, low-density lipoprotein cholesterol level, hypertension and body mass index. HbA1c level was higher in subjects with plaques in carotid arteries (P = 0·01). There was a positive and linear relationship between HbA1c levels and the probability of having plaques, thickened carotid IMT or both (P for all comparisons, <0·05). The ability of HbA1c levels to predict thickened carotid IMT or the presence of plaques was only modest {the optimal cutoff of HbA1c level [5·7%] was determined from the receiver operating characteristic (ROC) curve (sensitivity = 67%, specificity = 61%) and the area under the ROC curve [0·666]}.
Thus, HbA1c level is associated with subclinical atherosclerosis in carotid arteries in a Chinese population. The relationship is linear without an inflection point. However, HbA1c criterion is not a useful marker for the identification of subclinical atherosclerosis.
血红蛋白 A1c（HbA1c）水平与中国人颈动脉亚临床动脉粥样硬化之间的关系尚不清楚。目的、设计和方法：本研究旨在探讨这种关系，并评估 HbA1c 水平在中国人中预测颈动脉粥样硬化的能力。这是一项横断面研究，共纳入 541 名无已知糖尿病的受试者（台湾生活方式研究）。在研究期间，约有 67（9.2%）名受试者新诊断为糖尿病。使用超声心动图确定颈动脉内膜-中层厚度（IMT）和颈动脉斑块的存在。
在调整年龄、性别、吸烟、低密度脂蛋白胆固醇水平、高血压和体重指数后，所有受试者的 HbA1c 水平与颈动脉 IMT 呈正相关（β=0.018，P=0.03）。颈动脉斑块患者的 HbA1c 水平较高（P=0.01）。HbA1c 水平与斑块、颈动脉 IMT 增厚或两者均存在正相关和线性关系（所有比较的 P 值均<0.05）。HbA1c 水平预测颈动脉 IMT 增厚或斑块存在的能力仅中等{最佳 HbA1c 水平截断值[5.7%]由接收者操作特征（ROC）曲线确定（灵敏度=67%，特异性=61%），ROC 曲线下面积[0.666]}}。
因此，HbA1c 水平与中国人颈动脉亚临床动脉粥样硬化有关。这种关系是线性的，没有转折点。然而，HbA1c 标准不是识别亚临床动脉粥样硬化的有用标志物。
