非糖尿病者糖化血红蛋白水平对早期动脉粥样硬化的影响

Relationship between glycated hemoglobin Alc and arteriosclerosis in non-diabetes Chinese adults

目的探讨中国成年非糖尿病者糖化血红蛋白（HbAlc）水平与早期动脉粥样硬化的关系，评估年龄、血压、血脂等因素对该关系的影响。方法选择2011年6月至2012年3月徐州地区健康体检人群5514名，年龄19～90岁，对符合要求的5098名非糖尿病者进行体格检查并抽取空腹血进行生化检测，测定颈一股动脉脉搏波传导速度（c-fPWV）水平并进行分析。计数资料问的比较采用χ2检验，组间比较采用单因素方差分析。交互作用检测将在模型中引入交互作用相，交互关系的验证用似然比检验（LRT）。结果随着HbAI（3、空腹血糖、口服葡萄糖耐量试验（OGTT）2h血糖水平升高，c-fPWV呈显著上升趋势（趋势P值〈0．0001），校正年龄、性别、体质指数（BMI）、血压、心率和血脂后，c-fPWV仍随着HbAlc水平的升高而升高（趋势P值=0．004）。此外，HbAlc与年龄存在交互作用而对c-fPwV产生影响（P〈0．0001），当研究对象年龄≥60岁、收缩压≥140mmHg（1mmHg=0．133kPa）和（或）舒张压≥90mmHg时，c-fPWV随着HbAlc水平的升高而呈显著上升趋势（趋势P值分别为0．004、0．028）。结论非糖尿病者HbAlc水平与早期动脉粥样硬化具有相关性，并独立于其他代谢危险因素。高龄和高血压对HbAlc与c-fPWV之间的相关性起修饰作用。

Objective To explore the association of glycated hemoglobin Alc （HbA1 c ） in non- diabetes with the early stage of arteriosclerosis, and evaluate the modification effects of age, blood pressure, lipids et al in non-diabetes Chinese adults. Methods We performed a community-based health examination survey for 5514 individuals （19 -90 yrs old） who were randomly selected from residents living in the urban area of Xuzhou city. In total 5098 non-diabetes individuals were included in the final analyses, physical measurements, biomarkers and carotid-to-femoral pulse wave velocity （c-fPWV） were detected. Data management and statistical analysis were conducted using SPSS 15.0 statistical software, Chi-square test were used to calculate the count data, comparisons between groups were assessed by one-way analysis of variance. Results Along with the increased HbAlc, fasting plasma glucose and oral glucose tolerance test （OGTF） 2 h glucose levels, the prevalence of c-fPWV was significantly higher （ P for trend 〈 0. 0001 ） , adjusting for age, sex, body mass index（BMI）, blood pressure and lipids, c-fPWV was still along with the increased HbAlc（P for trend =0. 004）. In addition, HbAlc significantly interacted with age to affect c- fPWV （P for interaction 〈0. 0001 ）. The association was stronger in subjects who were elder （≥60 yrs; P for trend = 0. 004） and had higher blood pressure （systolic blood pressure≥ 140 mm Hg（ 1 mm Hg = 0. 133 kPa） and（or） diastolic blood pressure ≥90 mm Hg （P for trend =0.028））. Conclusions In non- diabetes, HbAle is associated with arteriosclerosis which independent of metabolic risk factors. Age and blood pressure may modify the associations between HbAlc and e-fPWV.