Department of Health Administration, Affiliated Central Hospital of Xinxiang Medical University, Xinxiang Central Hospital, Xinxiang, Henan, China.
Sci Rep. 2017 Mar 27;7:45406. doi: 10.1038/srep45406.
This study aimed to determine the association between the clinical reference range of serum glycated hemoglobin A1c (HbA1c) and thyrotropin (TSH) and the risk of coronary heart disease (CHD) in non-diabetic and euthyroid patients. We examined baseline HbA1c and TSH in 538 healthy participants, and then analyzed the associations and potential value of these indicators for predicting CHD using Cox proportional hazard and support vector machine analyses. During the median follow-up of 120 months, 39 participants later developed CHD. The baseline HbA1c and TSH within the reference range were positively associated with CHD risk. No correlation and interaction were found between the baseline HbA1c and TSH for the development of CHD. Disease event-free survival varied among participants with different baseline HbA1c quintiles, whereas disease event-free survival was similar for different TSH tertiles. The combination of these baselines showed sensitivity of 87.2%, specificity of 92.7%, and accuracy of 92.3% for identifying the participants who will later develop CHD. Relatively high but clinically normal HbA1c and TSH levels may increase the risk of CHD. Therefore, the combination of these indicators can serve as a biomarker for identifying healthy individuals from those who would later develop CHD.
本研究旨在探讨非糖尿病和甲状腺功能正常患者的血清糖化血红蛋白 A1c（HbA1c）和促甲状腺激素（TSH）的临床参考范围与冠心病（CHD）风险之间的关联。我们检查了 538 名健康参与者的基线 HbA1c 和 TSH，然后使用 Cox 比例风险和支持向量机分析来分析这些指标与 CHD 预测的关联及其潜在价值。在中位数为 120 个月的随访期间，39 名参与者后来发生了 CHD。在参考范围内的基线 HbA1c 和 TSH 与 CHD 风险呈正相关。基线 HbA1c 和 TSH 之间未发现相关性和相互作用与 CHD 的发展有关。不同基线 HbA1c 五分位组之间的无病生存差异，而不同 TSH 三分位组之间的无病生存差异相似。这些基线的组合对识别后来发生 CHD 的参与者具有 87.2%的敏感性、92.7%的特异性和 92.3%的准确性。相对较高但临床正常的 HbA1c 和 TSH 水平可能会增加 CHD 的风险。因此，这些指标的组合可以作为识别后来发生 CHD 的健康个体的生物标志物。
