绝经后非糖尿病患者糖化血红蛋白与冠状动脉严重程度的相关性研究

Glycosylated hemoglobin and coronary artery disease in postmenopausal non-diabetic patients

目的:探讨HbA1c与绝经后非糖尿病患者冠状动脉粥样硬化性心脏病严重程度的相关性。方法:采用回顾性分析方法连续性纳入2016年1月至2018年2月,于北京朝阳医院心脏中心造影诊断冠心病的绝经后非糖尿病患者共288例,有205例患者满足条件,根据入院的造影情况,利用Syntax评分,将符合条件的患者分为高危组(> 22分)及低危组(≤22分)。结果:两组患者间的HbA1c:[(5. 7±0. 4)%vs.(5. 9±0. 3)%,P=0. 016],TC:[(4. 41±1. 00) vs.(4. 74±1. 11) mmol/L,P=0. 03]差异有统计学意义。经过二元Logistic回归分析校正其他因素影响后,HbA1c仍可预测冠状动脉病变的严重程度(OR=6. 251,95%CI:1. 242～5. 981,P=0. 017)。通过ROC曲线分析分析,HbA1c值为5. 95%预测冠状动脉病变严重程度最佳,其灵敏度和特异度分别为52. 7%及70. 2%。结论:在绝经后非糖尿病患者中,HbA1c与冠状动脉病变程度密切相关,是冠状动脉病变复杂程度的预测因子。

Objective:To explore the relationship between the concentration of HbA1c and the severity of coronary atherosclerotic heart disease(CAD)in postmenopausal non-diabetic patients.Methods:A retrospective analysis was performed in288postmenopausal non-diabetic patients who underwent angiographic diag-nosis of CAD at the cardiac center of Beijing Chaoyang Hospital from January2016to February2018,about205patients meet the conditions.According to the angiography of admission,the eligible patients were divided into high-risk group(>22points)and low-risk group(≤22points)by Syntax score.Results:1)The Hemoglobin A1c and total cholesterol were significantly higher in high-risk group than that in low-risk group(5.7±0.4)%vs.(5.9±0.3)%(P=0.016),(4.41±1.00)vs.(4.74±1.11)mmol/L(P=0.03),(2)The binary Logistic regression analysis was used to correct the influence of other factors,the HbA1c concentration could still independently predict the severity of coronary lesions(95%CI:1.242~5.981,P=0.017),(3)Through analysis of ROC curve,we found that the HbA1c value was5.95%.The sensitivity and specificity were52.7%and70.2%,respectively.Conclusion:In postmenopausal non-diabetic patients,HbA1c concentration is significantly associated with the degree of CAD.It is an independent predictor of the complexity of CAD.