体检人群糖化白蛋白与动脉硬化的相关性研究  

Association between glycated albumin and arterial stiffness in a health screening population

作　　者：董剩勇 王维民[2] 曾强[2] 

机构地区：[1]总参管理保障部保健处,北京100034 [2]解放军总医院健康管理研究院

出　　处：《中华健康管理学杂志》2015年第2期118-123,共6页Chinese Journal of Health Management

基　　金：基金项目：国家科技支撑计划（2012BA137804）

摘　　要：目的 探讨体检人群中糖化白蛋白（GA）水平与动脉硬化的相关性的早期防治提供新途径。方法 2012年1月至2014年6月在解放军总医院体检的18岁以上11014名，其中男性6187名（56．2％），女性4827名（43．8％），平均年龄为（46．8＋7．8）岁，参加常规体检的研究对象进行问卷调查、血清GA和同型半胱氨酸（HCY）N定以及桡动脉-踝动脉脉搏波传导速度（baPWV）和中心动脉收缩压（cSBP）的检测。采用t检验、方差分析、卡方检验、多元回归分析以及分层分析GA与HCY、baPWV和cSBP的相关性。结果 男性研究对象GA平均水平（13．69±2．69）低于女性（13．82±1．92）（t=2．78，P=0．005）。不管是男性还是女性，随着GA水平的升高，baPWV（男性：F=53．9，P〈0．001；女性：F=37．7，P〈0．001）和cSBP（男性：F=10．3，P〈0．001；女性：F=13．5，P〈0．001）水平逐渐升高。在校正年龄、高血压史、糖尿病史、家族糖尿病史、吸烟、体质指数、腰围、血压、血脂、肾功能、空腹血糖、餐后2h血糖和糖化血红蛋白后，男性血清GA水平仍与baPWV（／3=0．019；95％CI：0．002—0．036；P=0．032）和cSBP（／3=0．251；95％CI：0．107～0．394；P=0．001）正相关。分层分析发现不管是否患有糖尿病或高血压，男性和女性血清GA均与baPWV和cSBP相关（P〈0．05）。但GA与HCY的相关性不显著。结论 在体检人群中，不管是男性还是女性以及是否患有糖尿病或高血压，血清GA水平均与baPWV和cSBP正相关。这种相关性在校正常规危险因素以及血糖指标后仍存在。提示GA可能是一个对于动脉硬化有预测价值的指标。Objective Serum glycated albumin （GA） is associated with the levels of blood glucose and short term glycemic fluctuation. The aim of this study was to investigate the associations between GA and arterial stiffness in a health screening population. Method A total of 11 014 participants （men, 56.2%; mean age, 46.8±7.8 years） who attended physical examination were invited and had completed standardized questionnaires. Serum GA and homocysteine （HCY）, brachial-ankle pulse wave velocity （baPWV）, and central systolic blood pressure （cSBP） were measured. A series of single and multiple factor analyses and stratified analysis were performed. Result The mean level of serum GA was lower in men （13.69± 2.69） than in women （13.82 ±1.92） （t=2.78, P=0.005）. The values of baPWV （men： F=53.9, P for trend〈0.001; women： F=37.7, P for trend〈0.001） and cSBP （men： F=10.3, P for trend〈0.001; women： F=13.5, P for trend〈 0.001） increased with quartiles of GA levels in both men and women. After adjustment for age, history of hypertension, diabetes, family history of diabetes, smoking status, body mass index, waist circumference, blood pressure, blood lipids, kidney function, fasting glucose, postprandial glucose, and hemoglobin Ale, GA was positively associated with baPWV （β estimate, 0.019; 95% CI： 0.002-0.036; P=0.032） and cSBP （13 estimate, 0.251; 95% CI： 0.107-0.394; P=0.001） in men. Stratified analysis also showed that the positive associations of GA with baPWV and eSBP remained significant in men both with and without diabetes orhypertension （P〈0.05）. However, the association between GA and HCY was not significant in multifactor analysis and stratified analysis. The above results were similar in women. Conclusion Serum GA levels were positively associated with baPWV and cSBP not only in patients with diabetes or hypertension but also in participants without diabetes or hypertension after adjusting for conventional factors and glucose markers. The findings

关 键 词：糖化白蛋白 动脉硬化 同型半胱氨酸 脉搏波传导速度 收缩压 

分 类 号：R543.5[医药卫生—心血管疾病]