Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, No.158 Wuyang Avenue, Enshi City, 445000, Hubei Province, China.
Pediatrics Department, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, No.158 Wuyang Avenue, Enshi City, 445000, Hubei Province, China.
BMC Endocr Disord. 2021 Oct 11;21(1):198. doi: 10.1186/s12902-021-00863-x.
The incidence rate of diabetes is increasing year by year, seriously threatening human health. As a predictor of glycemic control, glycated hemoglobin is reported to be related to various complications and prognoses of diabetes. Besides, HDL-C dyslipidemia is a component of metabolic syndrome and may be related to various cardiovascular and cerebrovascular diseases. The principal objective of this project was to investigate the relationship between HDL-C and glycosylated hemoglobin in adult diabetic patients.
A total of 3171 adult diabetic patients aged 20 years and above were included in the present study from the National Health and Nutrition Examination Survey (NHANES). HDL-C and glycosylated hemoglobin were regarded as independent and dependent variables, respectively. EmpowerStats software and R (version 3.4.3) were used to examine the association between HDL-C and glycosylated hemoglobin.
HDL-C was inversely associated with glycohemoglobin after adjusting for other covariates (β = - 0.004, 95% CI:- 0.008 to - 0.000, p = 0.044). Race/ethnicity and age were considered the most prominent interactive factors that affect the relationship between HDL and glycosylated hemoglobin by the interaction analysis. A U-shaped association was detected between HDL-C and glycosylated hemoglobin for people of other race/ethnicity or aged 60 and above, which had an inflection point of HDL-C at 60 mg/dL. In contrast, we observed an inverted U-shaped distribution between HDL-C and glycosylated hemoglobin in people under 40 with point of inflection located at 60 mg/dL as well.
HDL-C in diabetic patients is inversely associated with glycosylated hemoglobin and may be relevant to glycemic control. However, a U-shaped relationship was also observed in a certain kind of people, which implied that, though HDL-C is considered as metabolism and anti-atherogenic property, for diabetics, it is not the higher, the better.
糖尿病的发病率逐年上升，严重威胁人类健康。糖化血红蛋白作为血糖控制的预测指标，据报道与糖尿病的各种并发症和预后有关。此外，高密度脂蛋白胆固醇（HDL-C）血脂异常是代谢综合征的一个组成部分，可能与各种心脑血管疾病有关。本项目的主要目的是研究成年糖尿病患者 HDL-C 与糖化血红蛋白之间的关系。
本研究共纳入了 3171 名年龄在 20 岁及以上的成年糖尿病患者，这些患者均来自国家健康与营养调查（NHANES）。将 HDL-C 和糖化血红蛋白分别视为独立变量和因变量。采用 EmpowerStats 软件和 R（版本 3.4.3）分析 HDL-C 与糖化血红蛋白之间的关系。
调整其他协变量后，HDL-C 与糖化血红蛋白呈负相关（β=-0.004，95%CI：-0.008 至-0.000，p=0.044）。种族/民族和年龄被认为是通过交互分析影响 HDL 与糖化血红蛋白之间关系的最显著交互因素。对于其他种族/民族或 60 岁及以上的人群，HDL-C 与糖化血红蛋白之间存在 U 型关系，HDL-C 的拐点为 60mg/dL。相比之下，我们在 40 岁以下的人群中观察到 HDL-C 与糖化血红蛋白之间呈倒 U 型分布，拐点也位于 60mg/dL。
糖尿病患者的 HDL-C 与糖化血红蛋白呈负相关，可能与血糖控制有关。然而，在某些人群中也观察到 U 型关系，这表明，尽管 HDL-C 被认为具有代谢和抗动脉粥样硬化特性，但对于糖尿病患者而言，HDL-C 并非越高越好。
