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血红蛋白Alc、糖化白蛋白和空腹血糖对中国成年人动脉僵硬度预测价值的比较

Comparison of Hemoglobin Alc, Glycated Albumin and Fasting Plasma Glucose for Prediction of Arterial Stiffness in Chinese Adults.

作者信息

Wen Jianghua, Hu Fang, Yang Qiong

机构信息

Department of Health Examination, Jiangmen Central Hospital, Jiangmen 529070, Guangdong, People's Republic of China.

Department of Endocrinology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2020 Jan 10;13:65-70. doi: 10.2147/DMSO.S230435. eCollection 2020.

Abstract

OBJECTIVE

Although diabetes is closely related to cardiovascular disease, there are some disputes whether diabetes can promote arterial stiffness. Therefore, the objective of this study is to compare the predictive abilities of related-glycemic markers including fast plasma glucose (FPG), glycated hemoglobin (HbAlc) and glycated albumin (GA) for the arterial stiffness.

METHODS

In the present study, 3640 subjects (2171 men, 1469 women) were enrolled, and anthropometrics, brachial ankle pulse wave velocity (baPWV) and other laboratory data were obtained. Spearman correlation and multivariate logistic regression analyses were used to evaluate the relationships between FPG, HbAlc, GA and baPWV.

RESULTS

Age, BMI, blood pressure, blood lipids, γ-Glutamyl transpeptidase, uric acid, hypersensitive C-reactive protein, baPWV, FPG, HbAlc, GA, estimated glomerular filtration rate and the incidences of diabetes and hypertension in high baPWV group were much greater than those in control group. Moreover, these above three glycemic markers were positively related to baPWV, and the correlation coefficient of HbAlc was the highest. After adjusting the above factors, HbAlc and FPG, but not GA, were still positively associated with baPWV regardless of diabetes status.

CONCLUSION

Our data demonstrated that, regardless of diabetes status, HbAlc and FPG were superior to GA for predicting arterial stiffness and HbAlc had the highest correlation with arterial stiffness, revealing that HbAlc may be regarded as an early diagnosis marker for atherosclerosis.

摘要

目的

尽管糖尿病与心血管疾病密切相关,但糖尿病是否会促进动脉僵硬度仍存在一些争议。因此,本研究的目的是比较包括空腹血糖(FPG)、糖化血红蛋白(HbAlc)和糖化白蛋白(GA)在内的相关血糖标志物对动脉僵硬度的预测能力。

方法

在本研究中,纳入了3640名受试者(男性2171名,女性1469名),并获取了人体测量学、臂踝脉搏波速度(baPWV)及其他实验室数据。采用Spearman相关性分析和多因素logistic回归分析来评估FPG、HbAlc、GA与baPWV之间的关系。

结果

高baPWV组的年龄、体重指数、血压、血脂、γ-谷氨酰转肽酶、尿酸、超敏C反应蛋白、baPWV、FPG、HbAlc、GA、估算肾小球滤过率以及糖尿病和高血压的发生率均显著高于对照组。此外,上述三种血糖标志物与baPWV呈正相关,其中HbAlc的相关系数最高。在调整上述因素后,无论糖尿病状态如何,HbAlc和FPG仍与baPWV呈正相关,而GA则无此相关性。

结论

我们的数据表明,无论糖尿病状态如何,HbAlc和FPG在预测动脉僵硬度方面优于GA,且HbAlc与动脉僵硬度的相关性最高,这表明HbAlc可被视为动脉粥样硬化的早期诊断标志物。

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