代谢综合征患者糖化白蛋白及糖化血红蛋白比值与全因死亡率的关系  

Relationship between the glycated albumin to glycated hemoglobin ratio and all-cause mortality in patients with metabolic syndrome

作　　者：刘早玲[1] 唐溢乐 苏津 杨紫森 LIU Zao-ling;TANG Yi-le;SU Jin;YANG Zi-sen(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang 830000,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830000

出　　处：《现代预防医学》2024年第23期4225-4230,共6页Modern Preventive Medicine

基　　金：国家自然科学基金项目(82160605);新疆维吾尔自治区“十四五”高等学校特色学科-公共卫生与预防医学。

摘　　要：目的分析成人代谢综合征(metabolic syndrome,MetS)患者糖化白蛋白及糖化血红蛋白(GA/HbA1c)比值与全因死亡率之间的关系。方法本研究为回顾性队列研究,选用美国国家健康和营养调查(NHANES)和美国国家死亡索引(NDI)1999—2004年数据库。共纳入1497例符合条件的参与者,随访至2019年12月31日。使用Kaplan-Meier生存曲线、多因素加权Cox回归和限制性立方样条分析评估MetS患者GA/HbA1c比值和全因死亡率之间的关系。结果在中位随访16.3年期间,55224898例符合纳入标准的加权人群共发生501例全因死亡。按GA/HbA1c比值加权三分位数将参与者分为T1、T2和T3三组,在校正协变量后,与最低三分位数(T1)相比,较高的GA/HbA1c比值(T3)与MetS患者的全因死亡风险升高(HR=1.335,95%CI:1.010~1.772)有关。限制性立方样条分析还揭示了GA/HbA1c比值与全因死亡率之间的“S”形关系(非线性P<0.05)。亚组分析(所有交互作用P>0.05)和敏感性分析(HR=1.344,95%CI:1.014~1.783)也呈现相似的结果。结论MetS患者的GA/HbA1c比值与全因死亡率之间存在非线性相关性,较高的GA/HbA1c比值与MetS患者全因死亡风险增加有关。Objective To analyze the relationship between the ratio of glycated albumin to glycated hemoglobin(GA/HbA1c)and all-cause mortality in adults with metabolic syndrome MetS.Methods This study is a retrospective cohort study utilizing data from the National Health and Nutrition Examination Survey(NHANES)and the National Death Index(NDI)from 1999 to 2004.A total of 1497 eligible participants were included and followed up until December 31,2019.The relationship between the GA/HbA1c ratio and all-cause mortality in MetS patients was assessed using Kaplan-Meier survival curves,multivariable weighted Cox regression,and restricted cubic splines.Results Among a weighted population of 55224898 eligible individuals with a median follow-up of 16.3 years,there were 501 cases of all-cause mortality.Participants were divided into three groups(T1,T2,T3)based on weighted tertiles of the GA/HbA1c ratio.After adjusting for covariates,a higher GA/HbA1c ratio(T3)was associated with an increased risk of all-cause mortality in MetS patients compared to the lowest tertile(T1)(HR=1.335,95%CI:1.010-1.772).The restricted cubic spline analysis also revealed a non-linear“S”shaped relationship between the GA/HbA1c ratio and all-cause mortality(non-linear P<0.05).Subgroup analyses(all interaction P>0.05)and sensitivity analyses(HR=1.344,95%CI:1.014-1.783)showed similar results.Conclusion There is a non-linear association between the GA/HbA1c ratio and all-cause mortality in patients with metabolic syndrome,with higher GA/HbA1c ratios linked to an increased risk of all-cause mortality in these patients.

关 键 词：代谢综合征 糖化白蛋白 糖化血红蛋白 全因死亡率 NHANES 

分 类 号：R589[医药卫生—内分泌]