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糖化血红蛋白与冠心病患者颈动脉斑块的相关性:一项回顾性临床研究。

Association of HbA1c with carotid artery plaques in patients with coronary heart disease: a retrospective clinical study.

机构信息

Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

出版信息

Acta Cardiol. 2023 Jun;78(4):442-450. doi: 10.1080/00015385.2022.2040822. Epub 2022 Mar 31.

Abstract

BACKGROUND AND AIMS

Haemoglobin A1c (HbA1c) levels have been shown to be related to carotid artery plaques. However, studies on the relationship between HbA1c levels and carotid artery plaques in patients with coronary heart disease (CHD) are limited and inconsistent. Our objective was to examine the correlation between HbA1c levels and carotid artery plaques in patients with CHD.

METHODS

The study comprised 9275 Chinese adults with CHD from January 1, 2014, to September 30, 2020. HbA1c levels were assessed, and colour Doppler ultrasound was used to evaluate the carotid artery, including plaque presence, intima-media thickness, and plaque echo properties, to investigate the association between HbA1c and carotid plaque. A logistic regression model was used to assess the association between carotid artery plaques, carotid plaque echogenicity, and HbA1c.

RESULTS

The HbA1c level of the plaque-present group was higher than that of the plaque-absent group [6.1 (5.6-7.2) vs. 5.8 (5.5-6.5),  < 0.001]. In multiple linear regression analysis, intima-media thickness was associated with HbA1c ( < 0.001). Logistic regression showed that a higher HbA1c level was associated with plaque incidence as well as hyperechoic and heterogeneous plaques ( < 0.001). These associations persist after adjusting for age, sex, blood pressure, lipid profiles, alcohol consumption, and tobacco exposure.

CONCLUSION

HbA1c levels are notably associated with carotid artery plaque incidence, intima-media thickness, and plaque echogenicity in patients with CHD. These findings show that different levels of HbA1c may be an indicator for carotid artery plaques and thus, should be observed in patients with CHD.

摘要

背景与目的

糖化血红蛋白(HbA1c)水平已被证明与颈动脉斑块有关。然而,关于冠心病(CHD)患者 HbA1c 水平与颈动脉斑块之间关系的研究有限且不一致。我们的目的是研究 CHD 患者的 HbA1c 水平与颈动脉斑块之间的相关性。

方法

本研究纳入了 2014 年 1 月 1 日至 2020 年 9 月 30 日期间的 9275 例中国成年 CHD 患者。评估了 HbA1c 水平,并使用彩色多普勒超声评估颈动脉,包括斑块存在、内膜中层厚度和斑块回声特性,以研究 HbA1c 与颈动脉斑块之间的关系。使用逻辑回归模型评估颈动脉斑块、颈动脉斑块回声特性与 HbA1c 之间的关系。

结果

有斑块组的 HbA1c 水平高于无斑块组[6.1(5.6-7.2)比 5.8(5.5-6.5), < 0.001]。在多元线性回归分析中,内膜中层厚度与 HbA1c 相关( < 0.001)。逻辑回归显示,较高的 HbA1c 水平与斑块发生率以及强回声和不均匀斑块相关( < 0.001)。这些关联在调整年龄、性别、血压、血脂谱、饮酒和吸烟暴露后仍然存在。

结论

HbA1c 水平与 CHD 患者颈动脉斑块发生率、内膜中层厚度和斑块回声特性显著相关。这些发现表明,不同水平的 HbA1c 可能是颈动脉斑块的一个指标,因此,应在 CHD 患者中进行观察。

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