非糖尿病人群中糖化血红蛋白与心血管疾病危险因素的相关性研究

Study on the correlation between HbA1c and cardiovascular risk factors in non-diabetic population

目的探讨非糖尿病人群中糖化血红蛋白(HbA1c)与心血管危险因素的关系,明确HbA1c对非糖尿病人群心血管危险因素的预测意义。方法采用横断面研究方法,选择古城社区自愿参加糖尿病筛查的资料完整并符合入选条件的2 007例(男650例,女1 357例)。以HbA1c 6.5%为糖尿病诊断界值,每0.5为级差,以高血压、血脂紊乱、超重或肥胖、年龄(男>45岁、女>55岁)、HbA1c≥6.0%及空腹血糖(FBG)≥6.1 mmol/L为心血管危险因素,对不同HbA1c组中的个体所拥有的危险因素进行个数统计分析。同时将受检者按照所拥有的危险因素个数分组为0,1,2,3及4个以上组,比较不同组的危险因素的均值。通过Logistic回归分析HbA1c与心血管危险因素的相关性。结果①随着HbA1c的升高,有3个以上危险因素的频数逐渐增多。②HbA1c在不同危险因素个数组的均值随危险因素个数的增加而增加,并且组间比较有显著性差异(P<0.001)。③Logistic回归分析显示HbA1c与FBG受损及糖耐量减低相关性最强,年龄次之。结论6.0%<HbA1c<6.5%是非糖尿病人群心血管危险因素高发人群;HbA1c水平与FBG受损及糖耐量减低高度相关,可能是独立于其他心血管危险因素以外的非糖尿病人群的心血管危险因素预测指标。

Objective It is to investigate the relationship between HbA1c and cardiovascular risk factors in non-diabetic population,and to clarify the predictive value of HbA1c on cardiovascular risk factors.Methods It is a cross section study.Total 2007 participants （male 650,female 1 357） undergoing diabetes mellitus screening with detail data and according with the selective conditions were recruited in Gucheng Community.HbA1c ＞ 6.5％ was applied as diabetes cutoff,a 0.5 as a rank,factors including hypertension,dyslipideamia,over weight or obesity,age （male ＞ 45 years,female ＞ 55 years）,HbA1c ＞ 6.0％ and FPG≥6.1 mmol/l were taken as cardiovascular risk factors.Risk factors were counted in participants of different HbA1 c groups.Then,participants were grouped according to the risk factors frequency 0,1,2,3 and 4,and the mean of risk factors in different groups were compared.The correlation between HbA1c and cardiovascular risk factors were analyzed by Logistic analysis.Results ①The frequencies of 3 ～4 risk factors were increased with the increase of HbA1c.②The mean of HbA1c in different risk factors frequency groups increased with the increase of risk factor numbers,and the differences between the groups were significant（P ＜ 0.001）.③Multiple regression analysis showed that that HbA1c was closely related with FBG and impaired glucose tolerance（IGT）,age was the second correlation factor.Conclusion The frequencies of cardiovascular factors increase with the enhancing of HbA1 c rank.Nondiabetic people （6.0％ ＜ HbA1c ＜ 6.5％） are in high risk of cardiovascular risk factors.HbA1c level is correlated to 2hPG and FPG,it is a predictive factor of cardiovascular risk in nondiabetic people.