血红蛋白糖化指数与致动脉粥样硬化相关血脂指标关系的研究  

Study on the relationship between hemoglobin glycosylation index and arteriosclerosis-related blood lipids

作　　者：张晨 林璐[3] 孙迪 窦京涛[1] 王安平[1] 东黎光[5] 王淑玉[6] 吕朝晖[1] 母义明[1] Zhang Chen;Lin Lu;Sun Di;Dou Jingtao;Wang Anping;Dong Liguang;Wang Shuyu;Lyu Zhaohui;Mu Yiming(Department of Endocrinology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Graduate School,Chinese PLA General Hospital,Beijing 100853,China;Department of Endocrinology,Hainan Provincial People′s Hospital,Haikou 570311,China;Department of Endocrinology,Hainan Branch,Chinese PLA General Hospital,Sanya 572013,China;Physical Examination Center,Peking University Shougang Hospital,Beijing 100144,China;Beijing Hypertension League Institute,Beijing 100039,China)

机构地区：[1]解放军总医院第一医学中心内分泌科,北京100853 [2]解放军总医院研究生院,北京100853 [3]海南省人民医院内分泌科,海口570311 [4]解放军总医院海南分院内分泌科,三亚572013 [5]北京大学首钢医院体检中心,北京100144 [6]北京高血压联盟研究所,北京100039

出　　处：《中华内科杂志》2024年第6期579-586,共8页Chinese Journal of Internal Medicine

摘　　要：目的研究血红蛋白糖化指数(HGI)与低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、血浆致动脉粥样硬化指数(AIP)等致动脉粥样硬化相关血脂指标的关系。方法本研究为横断面研究,纳入2011年12月至2012年8月北京市苹果园社区参与调查的16049名受试者,依据HGI三分位数分为低、中、高3组(分别为5388、5249、5412人)。比较不同HGI组间致动脉粥样硬化相关血脂指标的差异,建立多因素logistics回归模型分析HGI与血脂指标异常的关联。按照不同糖代谢状态分层后,建立多因素logistics回归模型分析不同糖代谢人群中HGI与血脂指标的关系。结果16049名受试者平均年龄56岁,女性10452人(65.1%),糖耐量正常9093人、糖尿病前期4524人、糖尿病2432人。在总体人群中,随着HGI升高,LDL-C、non-HDL-C和AIP逐渐升高(趋势P值均<0.05),血脂异常患者比例均明显增加(χ^(2)=101.40、42.91、39.80,均P<0.001)。多因素logistic回归模型提示,在校正了年龄、性别、空腹血糖、高血压、体重指数、吸烟、饮酒等因素后,HGI与LDL-C、non-HDL-C、AIP异常均具有显著相关性(均P<0.05),在总体人群、糖耐量正常人群、糖尿病人群中,HGI与non-HDL-C异常的相关性最高(OR=1.325、1.678、1.274);在糖尿病前期人群中,HGI与LDL-C异常的相关性更高(OR=1.510);不同糖代谢人群中,AIP异常与HGI均具有相关性(OR=1.208~1.250),但并不优于non-HDL-C和LDL-C。结论在整体人群和不同糖代谢人群中,HGI与LDL-C、non-HDL-C和AIP等致动脉粥样硬化相关血脂指标密切相关,提示HGI可能是动脉粥样硬化性心血管疾病预测指标。Objective To study the relationship between hemoglobin glycation index(HGI)and blood lipid indices such as low-density lipoprotein cholesterol(LDL-C),non-high-density lipoprotein cholesterol(non-HDL-C),and plasma atherogenic index(AIP).Methods This cross-sectional study included 16049 participants from the Beijing Apple Garden community between December 2011 and August 2012.The subjects were divided into three groups based on the HGI quartile:low(n=5388),medium(n=5249),and high(n=5412).The differences in blood lipid indicators between different HGI groups were compared and multivariate logistic regression model was established to analyze the association between HGI and dyslipidemia.And multivariate logistic regression model was established to analyze the relationship between HGI and blood lipid indicators in different glucose metabolism populations.Results There were 16049 participants in all(mean age:56 years),including 10452 women(65.1%).They were classified into normal glucose tolerance(9093 cases),prediabetes(4524 cases),and diabetes(2432 cases)based on glucose tolerance status.In the general population,with the increase of HGI,LDL-C,non-HDL-C,and AIP gradually increased(all P values for trends were<0.05),and the proportion of abnormalities increased significantly(χ^(2)=101.40,42.91,39.80;all P<0.001).A multivariate logistic regression model was established,which suggested a significant correlation between HGI and LDL-C,non-HDL-C,and AIP(all P<0.05),after adjusting for factors such as age,sex,fasting blood glucose,hypertension,body mass index,smoking,and alcohol consumption.In the overall population,normal glucose tolerance group,and diabetes group,HGI had the highest correlation with non-HDL-C(OR values of 1.325,1.678,and 1.274,respectively);in the prediabetes group,HGI had a higher correlation with LDL-C(OR value:1.510);and in different glucose metabolism groups,AIP and HGI were both correlated(OR:1.208-1.250),but not superior to non-HDL-C and LDL-C.Conclusion HGI was closely related to LDL-C,non HDL-C,and

关 键 词：糖尿病 血红蛋白A 糖基化 大血管病变 血红蛋白糖化指数 

分 类 号：R543.5[医药卫生—心血管疾病] R587.1[医药卫生—内科学]