卒中高危人群糖化血红蛋白与颈动脉粥样硬化斑块的关系研究  

Association of Glycohemoglobin Level with Carotid Plaque in the Population at High Risk of Stroke

作　　者：祝刚[1] 杨沙[1] 李爱华 ZHU Gang;YANG Sha;LI Ai-Hua(Department of Neurology,Xiaogan Central Hospital,Xiaogan 432000,China;Integrated Department,Xiaogan Huangmailing Hospital,Xiaogan 432000,China)

机构地区：[1]湖北省孝感市中心医院神经内科,孝感432000 [2]湖北省孝感市黄麦岭医院综合科

出　　处：《中国卒中杂志》2020年第9期967-971,共5页Chinese Journal of Stroke

摘　　要：目的分析卒中高危人群糖化血红蛋白与颈动脉粥样硬化斑块的关系。方法2018年5-6月由孝感市中心医院按整群随机抽样方法,随机抽取孝感市城乡各1个社区居民进行筛查,通过问卷调查、体格检查、实验室检查、颈部血管超声检查筛选卒中高危人群纳入研究。根据颈动脉超声检测结果将卒中高危人群分为非斑块组和斑块组(颈动脉)。分别采用单因素和多因素Logistic回归,分析糖化血红蛋白与颈动脉斑块的关系,并根据年龄(60岁)、BM(I 24 kg/m2)、是否有高血压对研究人群进行分层分析,研究不同特征的卒中高危人群中糖化血红蛋白与颈动脉斑块的关系。结果最终纳入卒中高危人群629例,男性338例(53.74%),平均54.85±8.97岁,糖化血红蛋白平均浓度为4.70%±1.02%。其中斑块组患者215例(34.18%),非斑块组患者414例(65.82%)。与非斑块组患者相比,斑块组患者男性、卒中、TIA、高血压、超重患者比例更高,年龄更大,BMI、血压、空腹血糖、糖化血红蛋白、TC水平更高(均P<0.01)。校正其他危险因素后,糖化血红蛋白是颈动脉粥样硬化斑块发生的独立影响因素(每升高1%,OR 1.16,95%CI 1.01~1.31,P=0.018)。分层分析显示,年龄≥60岁(OR 1.48,95%CI 1.09~2.01,P=0.016)、BMI≥24 kg/m2(OR 1.97,95%CI 1.07~3.64,P=0.030)、高血压人群(OR 1.31,95%CI 1.06~1.62,P=0.013)中糖化血红蛋白均是颈动脉斑块发生的独立危险因素。结论卒中高危人群糖化血红蛋白与颈动脉斑块的发生密切相关,特别是在年龄≥60岁、BMI≥24 kg/m2和高血压人群中。Objective To analyze the relationship between glycohemoglobin(HbA1c)and carotid plaque in population at high risk of stroke.Methods Questionnaire,physical examination,laboratory examination,and cervical vascular ultrasonography were used to screen stroke high-risk patients in the population from an urban community and a rural community of Xiaogan Municipality by cluster random sampling method between 2018 May to June.The stroke high-risk people were divided into non-plaque group and plaque group based on the cervical vascular ultrasonography.Univariate and multivariate logistic regression analysis was used to analyze the correlation between HbA1c and carotid plaque,and stratified analysis was performed to study the difference in the relationship between HbA1c and carotid plaque in the high-risk population with different characteristics.Results Finally,a total of 629 subjects were included,with 338 males(53.74%)and a mean age of 54.85±8.97 years old,and the average concentration of HbA1c was 4.70%±1.02%.There were 215 patients(34.18%)in the plaque group and 414 patients(65.82%)in the non-plaque group.Compared to the non-plaque group,the plaque group had a higher proportion of males,stroke,TIA,hypertension and overweight individuals,and had higher age,BMI,blood pressure,fasting blood glucose,HbA1c,and TC levels(all P<0.01).After adjusting for the confounders,HbA1c concentration was an independent risk factor for carotid plaques(per an increase of 1%,OR 1.16,95%CI 1.01-1.31).The results of stratified analysis showed that HbA1c was an independent risk factor for carotid plaque in the subjects aged over 60 years old(OR 1.48,95%CI 1.09-2.01,P=0.016),and the ones with BMI≥24 kg/m2(OR 1.97,95%CI 1.07-3.64,P=0.030)and the ones with hypertension(OR 1.31,95%CI 1.06-1.62,P=0.013).Conclusions HbA1c is closely related to carotid plaque in stroke high-risk population,especially in the individuals aged over 60 years old,or with BMI≥24kg/m2 or hypertension.

关 键 词：糖化血红蛋白 颈动脉斑块 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]