糖化白蛋白与糖化血红蛋白对2型糖尿病患者冠状动脉疾病的影响分析

Effect Analysis between Glycated Albumin and Glycosylated Hemoglobin on Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus

目的分析糖化白蛋白(GA)与糖化血红蛋白(HbA1c)与2型糖尿病(T2DM)患者冠状动脉疾病(CAD)的相关性。方法选取2015年1月—2017年5月收治的284例T2DM患者进行研究,根据是否发生CAD分为观察组(发生CAD)与对照组(未发生CAD),每组142例。回顾性分析两组的临床资料,采用Gensini评分系统评估CAD的严重程度,并测定所选患者的GA、HbA1c、超敏C-反应蛋白(hs-CRP)、空腹血糖、血脂及肌酐水平。结果两组的性别、年龄、吸烟史、甘油三酯、hs-CRP、HbA1c和GA比较差异均有统计学意义(P<0.05,P<0.01);且观察组HbA1c和GA水平显著高于对照组(P<0.01)。男性、年龄>65岁、有吸烟史、hs-CRP>5 mg/L、HbA1c>7%和GA>20%是T2DM患者CAD发病的独立危险因素(P<0.05,P<0.01)。年龄、hs-CRP、HbA1c和GA与Gensini评分呈明显正相关关系(P<0.05,P<0.01)。HbA1c与GA是评估T2DM患者CAD严重程度的独立影响因素(P<0.01)。结论T2DM发生CAD患者的血清GA及HbA1c水平明显升高,血清GA及HbA1c水平是评估T2DM患者CAD严重程度的独立影响因素。

Objective To analyze correlation between glycated albumin(GA)and glycosylated hemoglobin(HbA1c)with coronary artery disease(CAD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 284 T2DM patients admitted during January 2015 and May 2017 were divided into observation group(having CAD,n=142)and control group(without having CAD,n=142)according to whether or not having CAD.In two groups,clinical data was retrospectively analyzed.Gensini scoring system was used to evaluate CAD severity,and levels of GA,HbA1c,high sensitive C-reactive protein(hs-CRP),fasting blood glucose,blood lipid and creatinine were measured.Results There were significant differences in gender,age,smoking history,triglyeride,hs-CRP,HbA1c and GA levels between two groups(P<0.05,P<0.01),and the HbA1c and GA levels in observation group were significantly higher than those in control group(P<0.01).Male,more than 65 years old,smoking history,hs-CRP more than 5 mg/L,HbA1c more than 7%and GA more than 20%were independent risk factors of CAD in T2DM patients(P<0.05,P<0.01).Age,hs-CRP,HbA1c and GA were positively correlated with Gensini score(P<0.05,P<0.01).HbA1c and GA were independent factors affecting severity of CAD in T2DM patients(P<0.01).Conclusion Serum GA and HbA1c levels in patients with T2DM having CAD can be found significantly increased,and therefore serum GA and HbA1c levels are independent factors affecting severity of CAD in T2DM patients.