Yu Jing, Gao Bo
Department of Medical Imaging, Guizhou Medical University, Guiyang, 550004, Guizhou Province, China.
Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou Province, China.
Diabetol Metab Syndr. 2021 Nov 19;13(1):136. doi: 10.1186/s13098-021-00747-z.
Coronary artery calcium score and glycated hemoglobin(HbA1c) are both considered risk factors for coronary heart disease. However, the relationship between coronary artery calcium score and HbA1c is still unclear. Consequently, the present study was undertaken to explore HbA1c association with coronary artery calcium score progression in South Korea.
This study is a secondary analysis based on a retrospective cohort study in which 8151 participants received Health examination kits at the Health Promotion Center, Samsung Medical Center in Seoul, South Korea, from March 1, 2003-December 31, 2013. Cox proportional-hazards regression model was then used to evaluate the independent relationship between HbA1c and coronary artery calcium score progression.
After adjusting potential confounding factors (age, sex, BMI, height, weight, SBP, DBP, TC, LDL-C, HDL-C, triglycerides, smoking status, alcohol consumption, reflux esophagitis status, hypertension, diabetes, dyslipidemia, ischemic heart disease and cerebrovascular disease), it was revealed that there was a nonlinear relationship between HbA1c and coronary artery calcium score progression, while the scoring point was 5.8%. The effect size was 2.06 to the left of the inflection point, while the 95% CI was 1.85 to 2.29. Whereas, the effect size was 1.04, on the right side of the inflection point while 95% CI was 0.99 to1.10.
The relationship between HbA1c and coronary artery calcium score progression is nonlinear. HbA1c is positively related to coronary artery calcium score progression when HbA1c level was less than 5.8%.
冠状动脉钙化积分和糖化血红蛋白（HbA1c）均被视为冠心病的危险因素。然而，冠状动脉钙化积分与HbA1c之间的关系仍不明确。因此，本研究旨在探讨韩国人群中HbA1c与冠状动脉钙化积分进展之间的关联。
本研究是一项基于回顾性队列研究的二次分析，2003年3月1日至2013年12月31日期间，8151名参与者在韩国首尔三星医疗中心健康促进中心接受了健康检查套餐。然后使用Cox比例风险回归模型评估HbA1c与冠状动脉钙化积分进展之间的独立关系。
在调整潜在混杂因素（年龄、性别、BMI、身高、体重、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、吸烟状况、饮酒、反流性食管炎状况、高血压、糖尿病、血脂异常、缺血性心脏病和脑血管疾病）后，发现HbA1c与冠状动脉钙化积分进展之间存在非线性关系，拐点处的评分点为5.8%。拐点左侧的效应大小为2.06，95%置信区间为1.85至2.29。而在拐点右侧，效应大小为1.04，95%置信区间为0.99至1.10。
HbA1c与冠状动脉钙化积分进展之间的关系是非线性的。当HbA1c水平低于5.8%时，HbA1c与冠状动脉钙化积分进展呈正相关。
