非糖尿病冠心病患者糖化血红蛋白与血脂相关性分析

Assessment of the Association between Glycated Hemoglobin Levels and Blood Lipids Levels in Nondiabetic Patients with Coronary Artery Disease

目的研究非糖尿病冠心病患者糖化血红蛋白(HbA1c)水平与血脂水平的相关性。方法入选排除糖尿病并经冠状动脉造影证实为冠心病的患者,空腹抽血收集HbA1c及血脂[包括胆固醇(TC)、低密度脂蛋白(LDL-C)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、脂蛋白a(Lp(a))]信息。按照三分位法将HbA1c分为高水平组(HbA1c>6.0%)、中水平组(5.7%<HbA1c<6.0%)、低水平组(HbA1c<5.7%),分析比较不同级别HbA1c患者的血脂水平。校正年龄、性别、体重指数(BMI)、入院收缩压(SP)、舒张压(DP)、入院前用药史(β受体阻滞剂和利尿剂)、肿瘤病史、高血压史、吸烟史、饮酒史、ALT、AST、血Cr等已知的影响血糖和血脂因素后,采用偏相关分析,评价HbA1c与血脂各项指标的相关性。结果研究共入选328例患者,HbA1c高水平组127例,中水平组99例,低水平组102例。随着HbA1c的增高,Lp(a)增高并有显著统计学差异(P=0.004)。TG随HbA1c的增高而增高,HDL-C在HbA1c高水平组低于中等水平及低水平组,但均未达统计学差异(P=0.871,P=0.550)。TC及LDL-C在各水平HbA1c组无明显差异。偏相关分析显示HbA1c与Lp(a)呈正相关(偏相关系数=0.167,P=0.004),而与TG、TC、HDL-C、LDL-C无相关性。结论非糖尿病冠心病患者HbA1c与Lp(a)呈正相关,而与TG、TC、HDL-C、LDL-C无显著相关性。

Objective To determine the association between glycated hemoglobin （HbAIc） levels and blood lipids levels in nondiabetic patients with coronary artery disease（CHD）. Methods Nondiabetic patients with confirmed CHD by coronary angiography were enrolled and collected the information of HbA1 c and total cholesterol （TC）, low density lipoprotein （LDL-C）, triglyceride （TG）, high density lipoprotein （HDL-C）, lipoprotein a （Lp （a））. The Levels of HbAlc were divided into 3 groups： high level group （HbAlc〉6.0%, medium level group ）5.7%≤HbAlc〈6.0%, low level group（HbAlc〈5.7%）. Then compared the blood lipids levels in different HbAlc groups, and assessed the association between HbAlc levels and blood lipids levels by partial correlation analysis with adjusting for age, sex, body mass index （BMI）, systolic blood pressure （SP）, diastolic blood pressure （DP）, medication history （beta blockers and diuretics）, tumor history, history of hypertension, smoking history, drinking history, ALT, AST and Cr. Results Total 328 patients were enrolled, there were 127 patients in high HbAlc level group, 99 patients inmedium level group and 102 patients in low level group. With increasing HbAlc levels, there was a significant increase in the Lp（a） levels, P=0.004. There were no significant difference about TC, LDL-C, TG, HDL-C indifferent HbAlc level groups. Partial correlation analysis showed that HbA l c was positively correlated with Lp （a） （partial correlation coefficient =0.167, P=0.004）, hut had no correlation with TG, TC, HDL-C and LDL-C. Conclusions HbAlc were positively correlated with Lp （a） and had no correlation with TG, TC, HDL-C and LDL-C in patients with nondiabetic coronary heart disease.