新诊2型糖尿病患者糖化血红蛋白水平与颈动脉内中膜厚度相关  

Association between glycated hemoglobin and carotid intima-media thickness in newly diagnosed type2 diabetes patients

作　　者：王彦[1] 张葵[1] 魏红霞[1] 徐志晔[1] 顾光煜[1] 王丽[1] 张正芳[1] 谭婷婷[1] 

机构地区：[1]南京大学医学院附属鼓楼医院检验科,210008

出　　处：《中华检验医学杂志》2014年第12期917-920,共4页Chinese Journal of Laboratory Medicine

基　　金：江苏省卫生厅科技项目（H201233）

摘　　要：目的探讨新诊2型糖尿病患者糖化血红蛋白（HbA1e）水平与颈动脉内中膜厚度（CIMT）的相关性。方法病例对照研究。选取南京市鼓楼医院2013年1月至2014年2月确诊的159例新诊2型糖尿病患者，按HbA1e。数值分为A组（HbA1e。≤7．0％，n=44），B组（7．0％〈HbA1e。≤9．0％，n=58）和c组（HbA1e〉9．0％，n=57）。检测新诊2型糖尿病患者糖化血红蛋白、血脂水平，并对患者进行颈动脉超声检查。采用Pearson直线相关对HbA1e，与各指标的相关性进行分析；采用单因素方差检验分析三组间的临床资料。同时采用logistic回归分析进行统计学分析。结果 单因素方差分析显示，c组右CIMT、左CIMT、平均CIMT和最大CIMT水平高于B组和A组，差异有统计学意义。Logistic逐步回归分析显示年龄和HbA1e。是最大CIMT的危险因素[年龄，风险比（OR）=1．103，95％置信区间（CI）=1．038～1．173，P〈0．05；HbA1e OR=2．531，95％CI=1．558～4．111，P〈0．05]。结论新诊2型糖尿病患者中，HbA1e。水平与CIMT显著相关，HbA1e。是最大CIMT增厚的独立危险因素，HbA1e。水平升高与最大CIMT增厚显著相关。（中华检验医学杂志，2014，37：917-920）Objective To examine the relationship between glycated hemoglobin （HbA1e） and carotid intima-media thickness （CIMT） in newly diagnosed 2 diabetes patients. Methods A total of 159 newly diagnosed type 2 diabetes patients visiting the Drum Tower Hospital, Nanjing, were collected from January 2013 to February 2014. All patients were divided into A group （HbA1e≤7. 0%, n =44）, B group （7.0% 〈 HbA1e ≤9.0%, n = 58） and C group （ HbA1e 〉 9.0%, n = 57 ） HbA1e, triacylglycerol （TG）, total cholesterol （TC）, high density lipoprotein cholesterol-C （HDL-C）, low density lipoprotein cholesterol- C （LDL-C） , lipoprotein A I （APOA I ） and lipoprotein B （APOB）. CIMT and the presence of carotid plaques were determined using uhrasonography. Pearson＇s correlation test was performed to examine various correlations. The effect of glycaemic control on various parameters was evaluated by one-way analysis of variance. Logistic regression analysis was used for statistical analysis. Results C group demonstrated significantly higher left CIMT, right CIMT, average CIMT and maximal CIMT levels as compared to A group and B group. Logistic stepwise regression analysis indicated that the independent factors of maximal CIMT were age and HbA1e [ age, odds ratio （OR） = 1. 103, 95% confidence interval （CI） ： 1. 038 - 1. 173, P 〈 0.05; HbA1e, OR=2.531, 95%CI：1.558 -4. 111, P〈0.05]. Conclusion HbA1e was significantly associated with CIMT in newly diagnosed diabetes patients. This study indicated that HbAlc might be an independent factor of elevated maximal CIMT in newly diagnosed type 2 diabetes patients. （ Chin J Lab Med, 2014,37：917-920）

关 键 词：糖尿病 2型 血红蛋白A 糖基化 颈动脉内膜中膜厚度 

分 类 号：R587.1[医药卫生—内分泌] R446.11[医药卫生—内科学]