糖化血红蛋白Alc与糖尿病合并外周动脉疾病的关系探讨

Relation of hemoglobin Alc to peripheral arterial disease with diabetes

目的探讨糖化血红蛋白Alc(HbAlc)与糖尿病合并外周动脉疾病(PAD)的关系。方法测定406例糖尿病患者(50～82岁)血脂、HbAlc。动脉硬化诊断仪测量双下肢裸肱指数(ABI)。结果糖尿病合并PAD患者HbAlc[(9.9±2.9)%]高于无合并PDA患者[(8.2土2.6)%](P<0.05),而两组年龄、性别、吸烟、高血压、高胆固醇和降血糖治疗差异无统计学意义(P>0.05)。糖尿病患者HbAlc≥7.0%时PAD发病率(12.2%)较HbAlc<7.0%(8.0%)高(P<0.05);调整影响因素后,Logistic分析提示HbAlc<7.0%和≥7.0%的OR分别为1.25(0.92～1.78)和1.92(1.22～3.62)。结论糖尿病外周动脉疾病患者存在高水平HbAlc,临床上应严格控制糖尿病外周动脉疾病患者血糖。

Objective To investigate the relationship between hemoglobin A1c and peripheral disease with diabetes. Methods Serum lipids and hemoglobin A1c were measured in diabetic patients （n=406） aged 50 to 82 years. Both lower extremities ankle-brachial indexes were measured using Japanese VS-1000 arteriosclerosis diagnometer. Results Hemoglobin A1c levels were （9.9±2.9）% in diabetic patients with peripheral arterial disease and （8.2 ± 2.6）% in those without peripheral arterial disease （P〈0.05）, but no significant differences were found in age, sex, smoking, hypertension, high cholesterol and hypoglyeemic therapy for the two groups （P〉0.05）. The prevalence of peripheral arterial arterial disease was 12.2% and 8.0% for diabetic patients with A1c≥7.0 and 〈 7.0%, respectively （P〈 0.05）. After multivariable adjustment, Logistic analysis showed that the odds ratio of peripheral disease was 1.25 （0.92±1.78） and 1.92 （1.22±3.62） for diabetic patients with A1c 〈7.0 and ≥7.0%, respectively. Conclusion An association exists between higher levels of hemoglobin Ale and peripheral arterial disease with diabetes. Blood glucose in diabetic patients with peripheral arterial disease should be intensively controlled clinically.