Shen Ying, Pu Li Jin, Lu Lin, Zhang Qi, Zhang Rui Yan, Shen Wei Feng
Department of Cardiology, Rui Jin Hospital, Shanghai, PR China.
Cardiology. 2012;123(2):84-90. doi: 10.1159/000342055. Epub 2012 Sep 25.
This study aimed to compare the value of serum glycated albumin (GA) level versus glycated hemoglobin A(1c) (HbA(1c)) for evaluating the presence and severity of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM).
Serum GA and blood HbA(1c) levels were measured in 829 consecutive T2DM patients with or without angiographically documented significant CAD (≥70% diameter stenosis).
Serum GA levels were higher in diabetic patients with significant CAD than in those without (20.57 ± 4.23 vs. 19.00 ± 4.48%; p < 0.001), but HbA(1c) was similar in the two groups (7.74 ± 1.34 vs. 7.51 ± 1.37% p > 0.05). Compared to HbA(1c), GA correlated more closely with the sum of significant stenotic lesions (r = 0.275, p < 0.001 and r = 0.092, p = 0.019) and the extent index (r = 0.375, p < 0.001 and r = 0.091, p = 0.019). The area under the curve of GA was larger than that of HbA(1c) for detecting the presence of significant CAD (0.637 vs. 0.568; p = 0.046) and 3-vessel disease (0.620 vs. 0.536; p = 0.039). GA, but not HbA(1c), was independently associated with significant CAD.
Serum GA level is a better indicator than HbA(1c) for evaluating the presence and severity of CAD and predicting major adverse cardiac events in patients with T2DM.
本研究旨在比较血清糖化白蛋白（GA）水平与糖化血红蛋白A1c（HbA1c）在评估2型糖尿病（T2DM）患者冠状动脉疾病（CAD）的存在及严重程度方面的价值。
对829例连续的T2DM患者进行血清GA和血液HbA1c水平测定，这些患者有或没有经血管造影证实的显著CAD（直径狭窄≥70%）。
有显著CAD的糖尿病患者血清GA水平高于无显著CAD者（20.57±4.23对19.00±4.48%；p<0.001），但两组的HbA1c水平相似（7.74±1.34对7.51±1.37%，p>0.05）。与HbA1c相比，GA与显著狭窄病变总和（r=0.275，p<0.001和r=0.092，p=0.019）以及范围指数（r=0.375，p<0.001和r=0.091，p=0.019）的相关性更密切。GA检测显著CAD存在的曲线下面积大于HbA1c（0.637对0.568；p=0.046）以及三支血管病变（0.620对0.536；p=0.039）。GA而非HbA1c与显著CAD独立相关。
血清GA水平在评估T2DM患者CAD的存在及严重程度以及预测主要不良心脏事件方面是比HbA1c更好的指标。
