不同糖代谢人群中血红蛋白糖化指数与非致死性心脑血管疾病的关系:一项基于REACTION数据的横断面研究  

Relationship between hemoglobin glycation index and non-fatal cardiovascular and cerebrovascular diseases:A cohort study based on REACTION data

作　　者：张晨 林璐[2] 孙迪 窦京涛[1] 王安平[1] 东黎光[4] 王淑玉[5] 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;Department of Endocrinology,Hainan Provincial People's Hospital,Haikou 570311,Hainan Province,China;Department of Endocrinology,Hainan Branch of Chinese PLA General Hospital,Sanya 572000,Hainan Province,China;Physical Examination Center,Shougang Hospital,Peking University,Beijing 100144,China;Beijing Hypertension League Institute,Beijing 100039,China;Graduate School,Chinese PLA General Hospital,Beijing 100853,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]海南省人民医院内分泌科,海南海口570311 [3]解放军总医院海南医院内分泌科,海南三亚572000 [4]北京大学首钢医院体检中心,北京100144 [5]北京高血压联盟研究所,北京100039 [6]解放军总医院研究生院,北京100853

出　　处：《解放军医学院学报》2024年第7期731-737,752,共8页Academic Journal of Chinese PLA Medical School

摘　　要：背景心脑血管疾病危害巨大,缺乏早期干预的预测指标。糖尿病是心脑血管疾病的主要病因之一,血红蛋白糖化指数(hemoglobin glycation index,HGI)可反映个体糖化能力。目的探讨总体及不同糖代谢人群的HGI与非致死性心脑血管疾病的关系。方法本研究为横断面研究,纳入中国2型糖尿病患者恶性肿瘤发生风险的流行病学研究(Risk Evaluation of Cancers in Chinese Diabetic Individuals:A Longitudinal Study,REACTION)北京分中心2011年受试者16470例,采集受试者一般特征以及非致死性心肌梗死、非致死性脑卒中(缺血性脑卒中和出血性脑卒中)等非致死性心脑血管疾病患病情况。在总体人群中依据基线HGI四分位切点进行四分位分组,使用Logistic回归分析HGI与非致死性心脑血管疾病的关系。结果16470例受试者依据HGI四分位切点分为Q1组(≤-0.26)4242例、Q2组(-0.26~-0.02)3915例、Q3组(-0.02~0.24)4223例、Q4组(>0.24)4090例;按照糖代谢状态分组后,糖耐量正常(normal glucose tolerance,NGT)9710例,糖尿病前期[糖耐量受损(impaired glucose tolerance,IGT)+空腹血糖受损(impaired fasting glucose,IFG)]4273例,糖尿病(diabetes mellitus,DM)2487例。总体人群中随着HGI升高,非致死性心脑血管疾病发生例数从Q1至Q4组分别为131例(3.1%)、125例(3.2%)、169例(4.0%)、174例(4.3%),逐渐升高(P=0.008);在NGT人群中,随着HGI升高,非致死性心脑血管疾病发生例数从Q1至Q4组分别为58例(2.5%)、63例(2.5%)、93例(3.5%)、75例(3.4%),呈上升趋势(P=0.046);而在空腹血糖受损和糖尿病人群中,非致死性心脑血管疾病发生情况在不同HGI组间差异无统计学意义(P=0.054、0.523);建立Logistic回归模型,校正相关影响因素后,发现在总体人群、糖耐量正常人群、糖尿病人群中,HGI与非致死性心脑血管疾病发生间无显著相关性。而在糖尿病前期人群中,相较于Q1组,Q2组(OR=1.762,95%CI:1.098~2.825,P=0.019)、Q3组(OR=2.005,Background Cardiovascular diseases have far-reaching consequences,lacking predictive indicators for early intervention.Diabetes is one of the main causes of cardiovascular and cerebrovascular diseases,and the hemoglobin glycation index(HGI)can reflect the individual glycation ability.Objective To investigate the relationship between hemoglobin glycation index(HGI)and non-fatal cardiovascular and cerebrovascular diseases in general population and different glucose metabolism populations.Methods This study was a cross-sectional study,including 16470 subjects from the Beijing branch of the REACTION study,general characteristics of subjects and the occurrence of non-fatal myocardial infarction,non-fatal stroke(ischemic stroke and hemorrhagic stroke),and other non-fatal cardiovascular diseases were collected.The subjects were divided into four groups based on the baseline HGI quartile cut-off points in the overall population.Logistic regression analysis was used to explore the relationship between HGI and non-fatal cardiovascular diseases.Results The 16470 subjects were divided into Q1(≤-0.26,n=4242),Q2(-0.26 to-0.02,n=3915),Q3(-0.02 to 0.24,n=4223),and Q4(>0.24,n=4090)groups.After grouping by glucose metabolism status,there were 9710 individuals with normal glucose tolerance(NGT),4273 individuals with prediabetes(impaired glucose tolerance,impaired fasting glucose,IGT+IFG),and 2487 individuals with diabetes mellitus(DM).In the overall population,the occurrence of non-fatal cardiovascular and cerebrovascular diseases increased gradually from Q1 to Q4 as HGI increased,with rates of 3.1%,3.2%,4.0%,and 4.3%,respectively(P=0.008).In the NGT group,the occurrence of non-fatal cardiovascular and cerebrovascular diseases increased from Q1 to Q4,with rates of 2.5%,2.5%,3.5%,and 3.4%,respectively,showing an upward trend(P=0.046).However,in the IGT+IFG and DM groups,there was no significant difference in the occurrence of non-fatal cardiovascular and cerebrovascular diseases among the HGI groups(P=0.054,0.523).After adjusting

关 键 词：糖尿病 血红蛋白糖化指数 心脑血管病变 体检人群 流行病学 

分 类 号：R587.1[医药卫生—内分泌] R541.4[医药卫生—内科学] R743.1[医药卫生—临床医学]