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糖化血红蛋白指数与 2 型糖尿病患者非酒精性脂肪肝的相关性。

Association between hemoglobin glycation index and non-alcoholic fatty liver disease in the patients with type 2 diabetes mellitus.

机构信息

Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.

出版信息

J Diabetes Investig. 2023 Nov;14(11):1303-1311. doi: 10.1111/jdi.14066. Epub 2023 Aug 8.

Abstract

AIMS/INTRODUCTION: The hemoglobin glycation index (HGI) represent the disparity between actual glycated hemoglobin measurements and predicted HbA1c. It serves as a proxy for the degree of non-enzymatic glycation of hemoglobin, which has been found to be positively correlated with diabetic comorbidities. In this study, we investigated the relationship between HGI and non-alcoholic fatty liver disease (NAFLD), along with other relevant biological markers in patients with diabetes.

MATERIALS AND METHODS

This cross-sectional study consisted of 3,191 adults diagnosed with type 2 diabetes mellitus. We calculated the predicted glycated hemoglobin levels based on fasting blood glucose levels. Multivariate binary logistic regression analysis was conducted to examine the correlation between the HGI and NAFLD. Hepatic steatosis was diagnosed using ultrasonography.

RESULTS

Among all participants, 1,784 (55.91%) were diagnosed with NAFLD. Participants with confirmed NAFLD showed elevated body mass index, diastolic blood pressure, liver enzyme, total cholesterol, triglyceride, low-density lipoprotein and uric acid levels compared with those without NAFLD. In the unadjusted model, participants in the last tertile of HGI were 1.40-fold more likely to develop NAFLD than those in the first tertile (95% confidence interval 1.18-1.66; P < 0.001). In the fully adjusted model, those in the last tertile of HGI had a 39% increased risk of liver steatosis compared with confidence interval in the first tertile of HGI (95% confidence interval 1.12-1.74; P < 0.001).

CONCLUSIONS

A higher HGI suggests an elevated risk of developing NAFLD in patients with type 2 diabetes.

摘要

目的/引言:血红蛋白糖化指数(HGI)代表实际糖化血红蛋白测量值与预测 HbA1c 值之间的差异。它是血红蛋白非酶糖化程度的替代指标,已发现与糖尿病合并症呈正相关。在这项研究中,我们调查了 HGI 与非酒精性脂肪性肝病(NAFLD)以及 2 型糖尿病患者其他相关生物标志物之间的关系。

材料和方法

这项横断面研究包括 3191 名被诊断患有 2 型糖尿病的成年人。我们根据空腹血糖水平计算预测的糖化血红蛋白水平。进行多变量二元逻辑回归分析,以检查 HGI 与 NAFLD 之间的相关性。使用超声诊断肝脂肪变性。

结果

在所有参与者中,有 1784 人(55.91%)被诊断为 NAFLD。与没有 NAFLD 的参与者相比,确诊为 NAFLD 的参与者的体重指数、舒张压、肝酶、总胆固醇、甘油三酯、低密度脂蛋白和尿酸水平均升高。在未调整模型中,HGI 最后三分位数的参与者患 NAFLD 的可能性是 HGI 第一三分位数的参与者的 1.40 倍(95%置信区间 1.18-1.66;P<0.001)。在完全调整的模型中,HGI 最后三分位数的参与者患肝脂肪变性的风险比 HGI 第一三分位数的参与者高 39%(95%置信区间 1.12-1.74;P<0.001)。

结论

较高的 HGI 表明 2 型糖尿病患者发生 NAFLD 的风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cc0/10583654/004feb6d8e29/JDI-14-1303-g001.jpg

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