National Center for Chronic Non-communicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Division of Epidemiology, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Diabetes Res Clin Pract. 2021 Mar;173:108672. doi: 10.1016/j.diabres.2021.108672. Epub 2021 Jan 21.
To evaluate the independence of the effect of 2-hour post-load plasma glucose (2hPG), fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) on cardiovascular disease (CVD) after adjusting for each other and non-glycemic factors.
We analyzed data from a nationally representative sample of 174,329 Chinese adults from a survey conducted in 2013-2014. The associations of glycemic measures with the risk of CVD were examined and compared by using logistic regression analyses.
After adjusting for non-glycemic factors, the odds ratio for one standard-deviation increase of 2hPG, FPG and HbA1c was 1.08 (95% confidence interval [CI]: 1.05-1.11), 1.02 (95% CI: 0.99-1.06) and 1.05 (95% CI: 1.02-1.07), respectively. The odds ratio for 2hPG (1.10, 95% CI: 1.05-1.16) remained statistically significant after FPG and HbA1c were added to the models, whereas the odds ratios for FPG and HbA1c became statistically insignificant after 2hPG was adjusted for. The results remained consistent across various scenarios.
2hPG showed an effect on cardiovascular risk which was independent from FPG and HbA1c, whereas whether the effects of FPG and HbA1c were independent from 2hPG was open to question. This finding calls for more research on how to better use FPG and HbA1c in diagnosing diabetes.
评估 2 小时餐后血糖（2hPG）、空腹血糖（FPG）和糖化血红蛋白（HbA1c）在相互调整以及非血糖因素后对心血管疾病（CVD）的影响是否具有独立性。
我们分析了 2013-2014 年进行的一项全国代表性的 174329 名中国成年人调查数据。使用逻辑回归分析检查和比较了血糖测量指标与 CVD 风险的相关性。
在调整非血糖因素后，2hPG、FPG 和 HbA1c 每增加一个标准差的比值比分别为 1.08（95%置信区间[CI]：1.05-1.11）、1.02（95% CI：0.99-1.06）和 1.05（95% CI：1.02-1.07）。在将 FPG 和 HbA1c 添加到模型中后，2hPG 的比值比（1.10，95% CI：1.05-1.16）仍然具有统计学意义，而在调整 2hPG 后，FPG 和 HbA1c 的比值比变得没有统计学意义。结果在各种情况下均保持一致。
2hPG 对心血管风险的影响独立于 FPG 和 HbA1c，而 FPG 和 HbA1c 的影响是否独立于 2hPG 则存在争议。这一发现呼吁进一步研究如何更好地使用 FPG 和 HbA1c 来诊断糖尿病。
