老年糖尿病人群HbA_(1c)水平对心血管疾病的预测作用

Role of HbA_(1c) level in predicting cardiovascular diseases in elderly patients with diabetes

目的观察老年糖尿病人群糖化血红蛋白(HbA_(1c))水平,探讨其与合并心血管疾病的相关性。方法以220例老年2型糖尿病患者为糖尿病组,214例非糖尿病老年患者为对照组,比较2组患者空腹静脉血血糖、糖化血红蛋白、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)含量。将220例糖尿病患者分为非冠心病组和冠心病组,比较2组HbA_(1c)含量。分析HbA_(1c)水平与收缩压、舒张压以及超敏C反应蛋白(Hs-CRP)水平的相关性。结果糖尿病组收缩压、舒张压、血糖相关指标(FPG、FINS)、Hs-CRP、HbA_(1c)水平均显著高于非糖尿病组(P<0.001),HDL-C水平显著低于非糖尿病组(P<0.001);冠心病组HbA_(1c)水平显著高于非冠心病组(P<0.001);老年糖尿病患者血清HbA_(1c)水平与SBP、DBP和Hs-CRP水平均呈正相关。结论老年糖尿病人群HbA_(1c)水平对心血管疾病具有一定的预测作用。

Objective To observe the Hb A1 clevel of elderly patients with diabetes and explore the correlation between Hb A1 clevel and cardiovascular diseases. Methods A total of 434 elderly patients were divided into type 2 diabetes group（ n = 220） and control group（ n = 214）. Fasting blood glucose（ FPG and FINS）,HbA_（1c）,triglyceride（ TG）,total cholesterol（ TC）,high density lipoprotein cholesterol（ HDL-C） and low density lipoprotein cholesterol（ LDL-C） levels were compared between two groups. Patients in the type 2 diabetes were divided into coronary heart disease group and non-coronary heart disease group,and HbA_（1c） level was compared. Correlation between HbA_（1c） level and systolic or diastolic blood pressure（ SBP or DBP） as well as high-sensitivity C-reactive protein（ Hs-CRP） was analyzed. Results The SBP,DBP,FPG,FINS,HbA_（1c） and Hs-CRP of type 2 diabetes group were significantly higher than those of non-type 2 diabetes group（ P〈 0. 001）,and the serum HDL-C level was significantly lower than controls. The HbA_（1c） level of the coronary heart disease group was significantly higher than that of the non-coronary heart disease group（ P〈 0. 001）. In elderly patients with diabetes,HbA_（1c） level was positively correlated with SBP（ P = 0. 004）,DBP（ P = 0. 018） and Hs-CRP levels（ P〈 0. 001）. Conclusion Serum HbA_（1c） level has a certain predicting effect on cardiovascular diseases in elderly patients with diabetes.