Li Chung-Hao, Lu Feng-Hwa, Yang Yi-Ching, Wu Jin-Shang, Chang Chih-Jen
Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
J Clin Med. 2019 May 1;8(5):603. doi: 10.3390/jcm8050603.
Previous studies exploring the association between arterial stiffness and prediabetes remain controversial. This study aimed to investigate the association of the different domains of prediabetes categorized by glycated hemoglobin A1c (A1c) 5.7-6.4%, impaired fasting glucose (IFG), fasting plasma glucose of 5.6-6.9 mmol/L, and impaired glucose tolerance (IGT), two-hour post-load glucose of 7.8-11.0 mmol/L, on arterial stiffness. These were measured by brachial-ankle pulse-wave velocity (baPWV). We enrolled 4938 eligible subjects and divided them into the following nine groups: (1) normoglycemic; (2) isolated A1c 5.7-6.4%; (3) isolated IFG; (4) IFG with A1c 5.7-6.4%; (5) isolated IGT; (6) combined IGT and IFG with A1c <5.7%; (7) IGT with A1c 5.7-6.4%; (8) combined IGT and IFG with A1c 5.7-6.4%; and (9) newly diagnosed diabetes (NDD). The baPWV values were significantly high in subjects with NDD (β = 47.69, 95% confidence interval (CI) = 29.02-66.37, < 0.001), those with IGT with A1c 5.7-6.4% (β = 36.02, 95% CI = 19.08-52.95, < 0.001), and those with combined IGT and IFG with A1c 5.7-6.4% (β = 27.72, 95% CI = 0.68-54.76, = 0.044), but not in the other subgroups. These findings suggest that increased arterial stiffness was found in prediabetes individuals having an A1c 5.7-6.4% with IGT, but not IFG. Isolated A1c 5.7-6.4% and isolated IGT were not associated with elevated arterial stiffness.
以往探索动脉僵硬度与糖尿病前期之间关联的研究仍存在争议。本研究旨在调查按糖化血红蛋白A1c（A1c）5.7 - 6.4%、空腹血糖受损（IFG）、空腹血糖5.6 - 6.9 mmol/L以及糖耐量受损（IGT）、餐后两小时血糖7.8 - 11.0 mmol/L分类的糖尿病前期不同领域与动脉僵硬度之间的关联。通过臂踝脉搏波速度（baPWV）对其进行测量。我们纳入了4938名符合条件的受试者，并将他们分为以下九组：（1）血糖正常组；（2）单纯A1c 5.7 - 6.4%组；（3）单纯IFG组；（4）IFG合并A1c 5.7 - 6.4%组；（5）单纯IGT组；（6）IGT合并IFG且A1c <5.7%组；（7）IGT合并A1c 5.7 - 6.4%组；（8）IGT合并IFG且A1c 5.7 - 6.4%组；以及（9）新诊断糖尿病（NDD）组。NDD组受试者（β = 47.69，95%置信区间（CI） = 29.02 - 66.37，< 0.001）、IGT合并A1c 5.7 - 6.4%组受试者（β = 36.02，95% CI = 19.08 - 52.95，< 0.001）以及IGT合并IFG且A1c 5.7 - 6.4%组受试者（β = 27.72，95% CI = 0.68 - 54.76，= 0.044）的baPWV值显著升高，但其他亚组未出现这种情况。这些发现表明，在A1c 5.7 - 6.4%合并IGT但不合并IFG的糖尿病前期个体中发现动脉僵硬度增加。单纯A1c 5.7 - 6.4%和单纯IGT与动脉僵硬度升高无关。
