Kang Seok Hui, Park Jong Won, Do Jun Young, Cho Kyu Hyang
a Division of Nephrology, Department of Internal Medicine , Yeungnam University Hospital , Daegu , Republic of Korea.
Ann Med. 2016 Sep;48(6):477-484. doi: 10.1080/07853890.2016.1197412. Epub 2016 Jun 19.
Regarding the association between glycated hemoglobin A1c (HbA1c) levels and microvascular complications, high HbA1c level in participants without diabetes mellitus (DM) may be associated with a high urinary albumin-to-creatinine ratio (UACR).
Twelve thousand seven hundred and seventy four participants without DM were included in this study. The participants were divided into three groups according to HbA1c levels: a Low group (<5.7%), Middle group (5.7-6.0%), and High group (>6.0%). A high UACR was defined as UACR ≥3.9 mg/g for men and UACR ≥7.5 mg/g for women.
The proportions of participants with a high UACR in the Low, Middle, and High groups were 22.4%, 27.9%, and 38.1%, respectively. Both univariate and multivariate analyses showed that logUACR was greatest in the High group compared to the other groups. For participants without metabolic syndrome (MetS), the proportions of participants with high UACR and logUACR values were greatest in the High group compared to the other groups. For participants with MetS, no differences were found for proportions of participants with high UACR and logUACR values in the Low, Middle, and High groups.
Non-DM participants with relatively high HbA1c levels should be closely monitored for UACR, especially if participants do not have MetS. KEY MESSAGES HbA1c level was positively associated with the proportion of participants with a high UACR and logUACR in participants without DM. For participants without MetS, the proportion of participants with a high UACR was greater in the High group than in the other groups and logUACR was greatest in the High group compared to the other groups. For participants with MetS, there were significant associations between HbA1c and the proportion of participants with a high UACR as a categorical variable or logUACR as a continuous variable, but the statistical significance of this finding was weak. No differences were found for proportions of participants with high UACR and logUACR values in the Low, Middle, and High groups.
关于糖化血红蛋白A1c（HbA1c）水平与微血管并发症之间的关联，无糖尿病（DM）参与者的高HbA1c水平可能与高尿白蛋白肌酐比（UACR）相关。
本研究纳入了12774名无DM的参与者。根据HbA1c水平将参与者分为三组：低水平组（<5.7%）、中等水平组（5.7 - 6.0%）和高水平组（>6.0%）。高UACR定义为男性UACR≥3.9mg/g，女性UACR≥7.5mg/g。
低水平组、中等水平组和高水平组中高UACR参与者的比例分别为22.4%、27.9%和38.1%。单因素和多因素分析均显示，与其他组相比，高水平组的logUACR最高。对于无代谢综合征（MetS）的参与者，与其他组相比，高水平组中高UACR和logUACR值的参与者比例最高。对于有MetS的参与者，低水平组、中等水平组和高水平组中高UACR和logUACR值的参与者比例未发现差异。
应密切监测HbA1c水平相对较高的非DM参与者的UACR，特别是那些没有MetS的参与者。关键信息 HbA1c水平与无DM参与者中高UACR和logUACR的参与者比例呈正相关。对于无MetS的参与者，高水平组中高UACR的参与者比例高于其他组，且与其他组相比，高水平组的logUACR最高。对于有MetS的参与者，HbA1c与作为分类变量的高UACR参与者比例或作为连续变量的logUACR之间存在显著关联，但这一发现的统计学意义较弱。低水平组、中等水平组和高水平组中高UACR和logUACR值的参与者比例未发现差异。
