新诊2型糖尿病患者糖化血红蛋白水平与颈动脉内中膜厚度相关被引量：2

Association between glycated hemoglobin and carotid intima-media thickness in newly diagnosed type2 diabetes patients

导出

摘要目的探讨新诊2型糖尿病患者糖化血红蛋白（HbA1e）水平与颈动脉内中膜厚度（CIMT）的相关性。方法病例对照研究。选取南京市鼓楼医院2013年1月至2014年2月确诊的159例新诊2型糖尿病患者，按HbA1e。数值分为A组（HbA1e。≤7．0％，n=44），B组（7．0％〈HbA1e。≤9．0％，n=58）和c组（HbA1e〉9．0％，n=57）。检测新诊2型糖尿病患者糖化血红蛋白、血脂水平，并对患者进行颈动脉超声检查。采用Pearson直线相关对HbA1e，与各指标的相关性进行分析；采用单因素方差检验分析三组间的临床资料。同时采用logistic回归分析进行统计学分析。结果单因素方差分析显示，c组右CIMT、左CIMT、平均CIMT和最大CIMT水平高于B组和A组，差异有统计学意义。Logistic逐步回归分析显示年龄和HbA1e。是最大CIMT的危险因素[年龄，风险比（OR）=1．103，95％置信区间（CI）=1．038～1．173，P〈0．05；HbA1e OR=2．531，95％CI=1．558～4．111，P〈0．05]。结论新诊2型糖尿病患者中，HbA1e。水平与CIMT显著相关，HbA1e。是最大CIMT增厚的独立危险因素，HbA1e。水平升高与最大CIMT增厚显著相关。（中华检验医学杂志，2014，37：917-920） Objective To examine the relationship between glycated hemoglobin （HbA1e） and carotid intima-media thickness （CIMT） in newly diagnosed 2 diabetes patients. Methods A total of 159 newly diagnosed type 2 diabetes patients visiting the Drum Tower Hospital, Nanjing, were collected from January 2013 to February 2014. All patients were divided into A group （HbA1e≤7. 0%, n =44）, B group （7.0% 〈 HbA1e ≤9.0%, n = 58） and C group （ HbA1e 〉 9.0%, n = 57 ） HbA1e, triacylglycerol （TG）, total cholesterol （TC）, high density lipoprotein cholesterol-C （HDL-C）, low density lipoprotein cholesterol- C （LDL-C） , lipoprotein A I （APOA I ） and lipoprotein B （APOB）. CIMT and the presence of carotid plaques were determined using uhrasonography. Pearson＇s correlation test was performed to examine various correlations. The effect of glycaemic control on various parameters was evaluated by one-way analysis of variance. Logistic regression analysis was used for statistical analysis. Results C group demonstrated significantly higher left CIMT, right CIMT, average CIMT and maximal CIMT levels as compared to A group and B group. Logistic stepwise regression analysis indicated that the independent factors of maximal CIMT were age and HbA1e [ age, odds ratio （OR） = 1. 103, 95% confidence interval （CI）： 1. 038 - 1. 173, P 〈 0.05; HbA1e, OR=2.531, 95%CI：1.558 -4. 111, P〈0.05]. Conclusion HbA1e was significantly associated with CIMT in newly diagnosed diabetes patients. This study indicated that HbAlc might be an independent factor of elevated maximal CIMT in newly diagnosed type 2 diabetes patients. （ Chin J Lab Med, 2014,37：917-920）

作者王彦张葵魏红霞徐志晔顾光煜王丽张正芳谭婷婷

机构地区南京大学医学院附属鼓楼医院检验科

出处《中华检验医学杂志》 CAS CSCD 北大核心 2014年第12期917-920,共4页 Chinese Journal of Laboratory Medicine

基金江苏省卫生厅科技项目（H201233）

关键词糖尿病 2型血红蛋白A 糖基化颈动脉内膜中膜厚度 Newly diagnosed type 2 diabetes patients Glycated hemoglobin Carotid intima-media thickness

分类号 R587.1 [医药卫生—内分泌] R446.11 [医药卫生—诊断学]

引文网络
相关文献

参考文献18

1Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China[ J]. N Engl J Med, 2010, 362: 1090-1101.
2Zoungas S, Chalmers J, Ninomiya T, et al. Association of HbAlc levels with vascular complications and death in patients with type 2 diabetes: evidence of glycaemic thresholds [ J ]. Diabetologia, 2012, 55 : 636-643.
3O'Leary DH, Polak JF, Kronmal RA, et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults[ J]. N Engl J Med, 1999, 340: 14-22.
4Emerging Risk Factors Collaboration, Sarwar N, Gao P, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative recta-analysis of 102 prospective studies[J]. The Lancet, 2010, 375: 2215-2222.
5Choi SW, Shin MH, Yun WJ, et al. Association between hemoglobin Alc, carotid atherosclerosis, arterial stiffness, and peripheral 'arterial disease in Korean type 2 diabetic patients[ J~. J Diabetes Complications, 2011, 25: 7-13.
6Hung CS, Lee PC, Li HY, et al. Haemoglobin Alc is associated with carotid intima-media thickness in a Chinese population [ J ]. Clin Endocrinol, 2011, 75: 780-785.
7Touboul PJ, Hennerici MG, Meairs S, et al. Mannheim carotid intima-media thickness consensus (2004-2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Maanheim, Germany, 2004, and Brussels, Belgium, 2006[ J]. Cerebrovasc Dis, 2007, 23: 75-80.
8Espeland MA, Tang R, Terry JG, et al. Association of risk factors with segment specific intimal-medial thickness of the extracranial carotid artery[ J]. Stroke, 1999, 30 : 1047-1055.
9Ashraf H, Boroumand MA, Amirzadegan A, et al. Hemoglobin Ale in non-diabetic patients: an independent predictor of coronary artery disease and its severity [ J 1. Diabetes Res Clin Pract, 2013, 102: 225-232.
10Greenland P, Alpert JS, Beller GA, et al. ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines [ J 1. J Am Cell Cardiol, 2010, 56: e50-e103.

二级参考文献22

1王束玫,冯月秋,高莉洁,常彩云,房学强.济南市城乡结合部居民糖尿病及相关知识知晓率的调查研究[J].中国初级卫生保健,2006,20(6):14-16. 被引量：14
2Herold K,Moser B,Chen Y,et al. Receptor for advanced glycation end products(RAGE) in a dash to the rescue:.inflammatory signals gone away in the primal response to stress. J Leukoc Biol, 2007,82 : 204-212.
3Jandeleit-Dahm K, Cooper ME. The role of AGEs in cardiovascular disease. Curr Pharm Des, 2008,14 : 979-986.
4Soro-Paavonen A, Watson AM, Li J, et al. Receptor for advanced glycation end products(RAGE) deficiency attenuates the development of atherosclerosis in diabetes. Diabetes, 2008,57 : 2461-2469.
5Takahashi HK, Mori S, Wake H, et al. Advanced glycation end products subspecies selectively induce adhesion molecule expression and cytokine production in human peripheral blood mononuclear cells. J Pharmacol Exp Ther,2009,330 : 89-98.
6Marsche G, Semlitsch M, Hammer A, et al. Hypochloritemodified albumin colocalizes with RAGE in the artery wall and promotes MCP-1 expression via the RAGE-Erk1/2 MAP- kinase pathway. FASEB J, 2007,21 : 1145-1152.
7Harja E, Bu DX, Hudson BI,et al. Vascular and inflammatory stresses mediate atherosclerosis via RAGE and its ligands in apoE-/- mice. J Clin Invest,2008,118:183-194.
8Reddy MA, Li SL, Sahar S, et al. Key role of Src kinase in S100B-induced activation of the receptor for advanced glycation end products in vascular smooth muscle cells. J Biol Chem, 2006,281 : 13685-13693.
9David KC, Scott RH, Nixon GF. Advanced glycation end products induce a proliferative response in vascular smooth muscle cells via altered calcium signaling. Biochem Pharmacol, 2008,76 : 1110-1120.
10Ge J,Jia Q, Liang C, et al. Advanced glycosylation end products might promote atherosclerosis through inducing the immune maturation of dendritic cells. Arterioscler Thromb Vasc Biol, 2005,25 : 2157-2163.