糖化血清白蛋白与冠心病的相关性研究

Associations of glycated albumin level with coronary artery disease

目的探讨糖化血清白蛋白水平（GA）与冠心病（CAD）的关系。方法入选2008年4月至2010年5月上海第六人民医院306例接受冠脉造影检查的患者（男201例，女105例），年龄38-86岁。CAD的诊断采用冠脉造影的金标准；代谢综合征采用2007年中国成人血脂异常防治指南中关于代谢综合征的诊断标准。结果（1）306例研究对象中，227例患者（74．2％）为CAD，其餐后2h血糖、GA、糖化血红蛋白显著高于非CAD组（均P〈0．05）。（2）亚组分析见到，正常糖耐量亚组CAD者的GA水平高于非CAD者[（15．0±2．1）％比（13．3±1．7）％，P〈0．01]，且冠脉单支病变者的GA水平[（14．8±2．1）％比（13．3±1．7）％，P〈0．05]及多支病变者[（15．1±2．1）％比（13．3±1．7）％，P〈0．05]均高于无病变者。在高血糖亚组中亦得出相似结果。（3）Logistic回归分析显示，校正CAD传统的危险因素后，无论在总人群、正常糖耐量亚组还是在高血糖亚组中，GA均为CAD的独立危险因素（P〈0．05）。结论CAD患者GA水平明显升高，GA不仅在高血糖人群的CAD发病中起重要作用，而且在正常糖耐量人群中亦是CAD的独立危险因素。

Objective To explore the associations of the level of glycated albumin （GA） withcoronary artery disease （CAD）. Methods A total of 306 patients undergoing coronary angiography （CA） were collected. There were 201 males and 105 females with an age range of 38 - 86 years. CA was the major diagnostic criteria of CAD. Metabohc syndrome was diagnosed according to the Guidehne on Prevention ＆ Treatment of Blood Lipid Abnormality in Chinese Adults. Results （1） CAD was found in 227 patients （74. 2% ）. The levels of 2 h postprandial glucose, GA and hemoglobin Alc in the CAD patients were higher than those in the non-CAD counterparts （ all P 〈 0. 05 ）. （2） In the subgroup of normal glucose tolerance （ NGR）, the CAD patients had a higher level of GA than the non-CAD patients （ （ 15.0 ＋ 2. 1 ） % vs （13.3 ±1.7）%, P 〈0. 01）. And the level of GA was higher in the patients with 1-vessel （（ 14. 8 ± 2.1）% vs （13.3±1.7）%, P〈0.05） and multi-vessel lesions （（15.1±2.1）% vs （13.3±1.7）%, P 〈 0. 05） than that in the non-CAD counterparts （ all P 〈 0. 05 ）. Similar results were obtained in the hyperglycemia subgroup. （3） Logistic regression demonstrated that the level of GA was independently correlated with CAD after adjusting other traditional factors among all subjects, NGR and hyperglycemia subgroup. Conclusions The serum level of GA becomes significantly elevated the CAD patients. And it is an independent risk factor of CAD in both hyperglycemic and NGR patients.