老年健康体检人群外周血红细胞分布宽度与糖化血红蛋白A1c的相关性研究  

Association of Peripheral Blood Red Blood Cell Distribution Width with Glycated Hemoglobin A1c in the Healthy Elderly Population for Check-ups

作　　者：张海霞[1] 郭杰[1] 袁宁[1] 张清泉 管新雨 郭杰 孟兆年[1] 侯敏 ZHANG Hai-xia;GUO Jie;YUAN Ning;ZHANG Qing-quan;GUAN Xin-yu;GUO Jie;MENG Zhao-nian;HOU Min(Department of Clinical Laboratory,Tianjin 300222,China;Department of Cardiology,Tianjin Chest Hospital,Tianjin 300222,China;IT Repayment,HC Consumer Finance Co.Ltd.,Tianjin 300457,China;Medical Laboratory,Tianjin Medical University,Tianjin 300203,China)

机构地区：[1]天津市胸科医院检验科,天津300222 [2]天津市胸科医院心内科,天津300222 [3]天津捷信消费金融有限公司IT Repayment,天津300457 [4]天津医科大学医学检验学院,天津300203

出　　处：《现代检验医学杂志》2020年第4期65-70,共6页Journal of Modern Laboratory Medicine

摘　　要：目的探讨老年健康体检人群红细胞分布宽度(red blood cell distribution width,RDW)是否与糖化血红蛋白A1c(glycated hemoglobin A1c,HbA1c)有关。方法利用回顾性研究方法收集2014年1月~2018年12月天津市胸科医院5408例60岁以上老年健康体检者的全血细胞计数(complete blood count,CBC)和HbA1c等结果,并进行相关统计分析。结果在研究人群中,RDW与HbA1c呈正相关,差异具有统计学意义(r=0.077,95%CI 0.050~0.105,P=0.000),即使在调整混杂因素之后亦是如此。在整个研究人群及无贫血组中,HbA1c>6.3%的个体其RDW水平及RDW>14.0%的比例均高于HbA1c≤6.3%的个体(Z=-7.932,-7.891,χ2=56.591,58.873,均P=0.000);且RDW水平随着HbA1c四分位数水平逐渐升高(H=188.047,P=0.000;经Bonferroni校正后P为0.000,均P<0.05)。而且,RDW>14.0%的比例随着HbA1c四分位数而增加,呈线性趋势(χ2=30.426,趋势性P=0.000)。Logistic回归分析证实RDW是HbA1c的独立危险因素[调整后比值比(odds ratio,OR)=1.050,95%CI为1.009~1.093,P=0.016]。HbA1c>6.3%的个体RDW>14.0%出现的风险是HbA1c≤6.3%个体的1.569倍(95%CI为1.395~1.765,P=0.000);而且,RDW>14.0%出现的风险随着HbA1c四分位数增加具有升高的线性趋势(趋势性P=0.000)。结论老年健康体检人群中,RDW与HbA1c呈正相关;RDW是HbA1c的独立风险因素,HbA1c升高的个体其RDW水平升高的风险增加。RDW或许可作为一个有效的生物标志物用于2型糖尿病(type 2 diabetes mellitus,T2DM)个体的风险评估。Objective To explore whether red blood cell distribution width(RDW)may be associated with glycated hemoglobin A1c(HbA1c)in the healthy elderly population for check-ups.Methods The study retrospectively analyzed the results of complete blood count(CBC)and HbA1c in 5408 individuals aged 60 years or older for routine health check-ups from January 2014 to December 2018.Results In the study population,RDW was significantly and positively associated with HbA1c(r=0.077,95%CI 0.050~0.105,P=0.000),even after adjustment.RDW value and the proportion of RDW>14.0%were both higher in individuals with HbA1c>6.3%(Z=-7.932,-7.891,χ2=56.591,58.873,all P=0.000).RDW levels gradually increased across quartiles of HbA1c(H=188.047,P=0.000;P after Bonferroni correction<0.05).In addition,there was a significant linear trend towards higher proportions of RDW>14.0%across quartiles of HbA1c(χ2=30.426,P value for trend=0.000).RDW was an independent risk factor for HbA1c[adjusted odds ratio(OR)=1.050,95%CI 1.009~1.093,P=0.016].The OR of HbA1c>6.3%vs HbA1c≤6.3%for RDW>14.0%was 1.569(95%CI 1.395~1.765,P=0.000).What’s more,observed a linear trend towards increasing ORs of having a higher RDW level across quartiles of HbA1c(P value for trend=0.000).Conclusion RDW was positively associated with HbA1c in the healthy elderly population.RDW is an independent risk factor for HbA1c,and individuals with elevated HbA1c had an increased risk of elevated RDW levels.RDW might serve as an effective biomarker for risk assessment of individuals at risk of type 2 diabetes mellitus(T2DM).

关 键 词：红细胞分布宽度 糖化血红蛋白A1C 糖尿病 2型糖尿病 

分 类 号：R446.11[医药卫生—诊断学]