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目的:研究糖调节受损人群中糖化血红蛋白(HbA1c)与颈动脉内中膜厚度(CIMT)的相关性。方法:采用横断面研究,在上海市嘉定区2 519名40岁以上的居民中纳入523例糖调节受损患者(6.1 mmol/L≤空腹血浆葡萄糖(FPG)<7.0 mmol/L和(或)7.8 mmol/L≤口服葡萄糖耐量试验2 h血浆葡萄糖水平(OGTT-2hPG)<11.0 mmol/L)。分析患者HbA1c水平与其两侧CIMT中较大值(CIMTmax)之间的关系。结果 :校正性别、年龄、FPG、2hPG、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、体质量指数(BMI)、是否有高血压、吸烟、饮酒后,HbA1c与CIMTmax呈显著正相关(β=0.034,P=0.01)。逐步多元回归分析结果显示,CIMTmax的独立危险因素为年龄、性别、HbA1c、吸烟,其中,HbA1c的回归系数为0.042(P=0.012)。将CIMTmax上三分位CIMTmax≥0.7定义为CIMTmax增厚,校正全部因素后,HbA1c每升高1个单位,CIMTmax增厚的风险增加87%[比值比(OR)=1.866,95%可信区间(CI):1.04～3.346,P=0.036]。结论:在糖调节受损人群中,HbA1c水平升高与CIMTmax增厚风险显著相关,HbA1c是CIMTmax增厚的独立危险因素。
AIM: To investigate the association between glycosylated hemoglobin (HbA1c) and carotid intima-media thickness (CIMT) in impaired glucose regulation. Methods: A cross-sectional study included 523 patients with impaired glucose regulation (6.1 mmol / L ≤ FPG and / or 7.0 mmol / L) in 2 519 residents over the age of 40 in Jiading District of Shanghai. 7.8 mmol / L ≤ oral glucose tolerance test 2 h plasma glucose level (OGTT-2hPG) <11.0 mmol / L). The relationship between the patient’s HbA1c level and the greater of its CIMTs (CIMTmax) was analyzed. RESULTS: Corrections of gender, age, FPG, 2hPG, TC, LDL-C, HDL-C, BMI, After smoking and drinking, there was a significant positive correlation between HbA1c and CIMTmax (β = 0.034, P = 0.01). The results of stepwise multivariate regression analysis showed that the independent risk factors of CIMTmax were age, sex, HbA1c, smoking, and the regression coefficient of HbA1c was 0.042 (P = 0.012). The CIMTmax of 0.7 on the CIMTmax was defined as CIMTmax thickening, with an increase of 1 unit per HbA1c, an 87% increase in the risk of CIMTmax thickening after adjusting for all factors [OR = 1.866, 95% confidence interval (CI): 1.04-3.346, P = 0.036]. CONCLUSIONS: Elevated HbA1c levels are associated with increased risk of CIMTmax in impaired glucose regulation, and HbA1c is an independent risk factor for CIMTmax.