非糖尿病患者糖化血红蛋白（HbA1c）与冠状动脉疾病严重程度的相关性——一项来自印度东北部的医院研究
Glycated Hemoglobin (HbA1c) Correlation with Severity of Coronary Artery Disease in Non-diabetic Patients - A Hospital based Study from North-Eastern India.
作者信息
Dutta Bornali, Neginhal Mahesh, Iqbal Farhin
机构信息
Associate Professor, Department of Cardiology, Gauhati Medical College , Guwahati, Assam, India .
Senior Resident, Department of Cardiology, Gauhati Medical College , Guwahati, Assam, India .
出版信息
J Clin Diagn Res. 2016 Sep;10(9):OC20-OC23. doi: 10.7860/JCDR/2016/22378.8525. Epub 2016 Sep 1.
INTRODUCTION
Glycated Hemoglobin (HbA1c) levels are predictive of cardiovascular disease and mortality in patients with diabetes mellitus, however, association of HbA1c with Coronary Artery Disease (CAD) in non-diabetics is inconsistent.
AIM
To evaluate the correlation between HbA1c level and severity of CAD in non-diabetic patients using SYNTAX score in a cohort of proven CAD on angiography at Gauhati Medical College, Guwahati, Assam, India, which is a major tertiary care hospital of North-Eastern India.
MATERIALS AND METHODS
We prospectively collected data of non-diabetic patients with proven CAD on angiography from June 2014 to June 2015. Patients were divided into four groups (interquartiles) according to HbA1c levels, less than 4.8%, 4.8% to 5.1%, 5.1% to 5.6%, and 5.6% to 6.5%. Severity of CAD was assessed using SYNTAX score and the number of coronary vessels diseased. We compared different quartiles of HbA1c with regard to SYNTAX score and number of diseased vessels.
RESULTS
A total of 346 patients were included in the study. Mean age was 58.1±10.4 years. Of the total 91.9% (318) were males, 44.8% (155) were hypertensives, 29.2% (101) were smokers and 34.7% (120) were dyslipidemic. We found that CAD severity by SYNTAX score as well as number of vessels involved was significantly different among quartiles (p-values <0.001 and <0.001 respectively). Increase in HbA1c level was strongly correlated with disease severity and higher SYNTAX score. A significant increase was noted in the mean number of diseased vessels (p-value <0.001) as HbA1c level increases. Age, gender, hypertension and dyslipidemia did not show significant difference among quartiles however smoking was found to be an independent predictor of severity of CAD by SYNTAX score (p <0.05).
CONCLUSION
From this clinical study, we can conclude that a significant correlation exists between HbA1c and severity of CAD by SYNTAX score as well as number of vessels involved in non- diabetes.
引言
糖化血红蛋白（HbA1c）水平可预测糖尿病患者的心血管疾病及死亡率，然而，HbA1c与非糖尿病患者冠状动脉疾病（CAD）之间的关联并不一致。
目的
在印度阿萨姆邦高哈蒂市高哈蒂医学院（印度东北部一家主要的三级护理医院）对一组经血管造影证实患有CAD的患者中，使用SYNTAX评分评估非糖尿病患者HbA1c水平与CAD严重程度之间的相关性。
材料与方法
我们前瞻性收集了2014年6月至2015年6月经血管造影证实患有CAD的非糖尿病患者的数据。根据HbA1c水平将患者分为四组（四分位数），即低于4.8%、4.8%至5.1%、5.1%至5.6%以及5.6%至6.5%。使用SYNTAX评分和病变冠状动脉血管数量评估CAD的严重程度。我们比较了不同HbA1c四分位数组的SYNTAX评分和病变血管数量。
结果
本研究共纳入346例患者。平均年龄为58.1±10.4岁。在所有患者中，91.9%（318例）为男性，44.8%（155例）患有高血压，29.2%（101例）为吸烟者，34.7%（120例）患有血脂异常。我们发现，不同四分位数组之间，SYNTAX评分所反映的CAD严重程度以及病变血管数量均存在显著差异（p值分别<0.001和<0.001）。HbA1c水平升高与疾病严重程度及更高的SYNTAX评分密切相关。随着HbA1c水平升高，病变血管的平均数量显著增加（p值<0.001）。年龄、性别、高血压和血脂异常在不同四分位数组之间未显示出显著差异，然而，吸烟被发现是SYNTAX评分所反映的CAD严重程度的独立预测因素（p<0.05）。
结论
从这项临床研究中，我们可以得出结论，在非糖尿病患者中，HbA1c与SYNTAX评分所反映的CAD严重程度以及病变血管数量之间存在显著相关性。
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