超重人群HbA1c与血小板参数及动脉粥样硬化研究

Relationship of HbA1c and Platelet Parameters and Atherosclerosis in Non-diabetic Overweight and Obese Subjects

目的在非糖尿病超重和肥胖体检人群中,研究糖化血红蛋白(HbA1c)与血小板参数及亚临床动脉粥样硬化的关系。方法回顾性纳入行健康体检的非糖尿病超重研究对象4393例,其中,超重3824例(87%),肥胖569例(13%)。年龄18~75岁,其中男性3570例,女性823例。检查传统心血管病危险因素:血压、糖代谢(FPG、HbA1c)、血脂(LDL-C、HDL-C、TC、TG)、尿酸(UA)、同型半胱氨酸(Hcy)和体重指数(BMI)。颈动脉彩超测量颈动脉内中膜厚度(CIMT)并检查有无斑块。分别检验血小板计数(PLT)、平均血小板体积(MPV)和血小板质量(PM)与HbA1c及其他研究变量之间的关系。在单因素分析中P<0.2的变量纳入多因素线性回归。采用Logistic回归分析研究HbA1c与亚临床动脉粥样硬化关系。结果多因素线性回归显示,PLT与HbA1c(P=0.000)、女性(P=0.000)、LDL-C(P=0.001)独立正相关,与年龄(P=0.000)独立负相关。MPV与LDL-C(P=0.016)、PLT(P=0.000)独立负相关,与尿酸(P<0.040)独立正相关。PM与HbA1c(P=0.000)、女性(P=0.000)、TC(P=0.016)独立正相关,与年龄(P=0.000)独立负相关。Logistic回归分析结果显示HbA1c升高,亚临床动脉粥样硬化风险增高(OR=1.436,95%CI:1.160~1.777)。结论在超重和肥胖的非糖尿病人群中,HbA1c是PLT、PM和亚临床动脉粥样硬化独立危险因素。

Objective To investigate the relationship of glycosylated hemoglobin(HbA1c)with platelet parameters and subclinical atherosclerosis in overweight and obese non-diabetic populations who experience physical examination.Methods A total of 4393 overweight non-diabetic subjects who underwent physical examination were enrolled retrospectively in this study.The subjects were between 18 and 75 years,of whom 3570 individuals were male(81.2%),3824 individuals were overweight(87%),and 569 individuals were obese(13%).Blood pressure,glycometabolism(fasting plasma glucose,HbA1c),blood lipid(LDL-C,HDL-C,TC,TG),uric acid(UA),homocysteine(Hcy),body mass index(BMI)were detected in all subjects,who underwent carotid color doppler ultrasound to measure carotid intima-media thickness(CIMT)and check for plaque.The relationships of platelet indices PLT,MPV and PM with HbA1c and other research variables were tested respectively.In univariate analysis,variables with P<0.2 were included in final multiple regression analysis.Logistic regression was used for studying the relationship between HbA1c and subclinical atherosclerosis.Results Multivariate linear regression indicated that PLT was associated independently and positively with HbA1c(P=0.000),female(P=0.000),and LDL-C(P=0.001),and associated independently and negatively with age(P=0.000).LDL-C(P=0.016)and PLT(P=0.000)negatively,and uric acid(P<0.040)positively,were significantly and independently associated to MPV in multiple regression analysis.PM was associated independently and positively with HbA1c(P=0.000),female(P=0.000),and TC(P=0.016),and associated independently and negatively with age(P=0.000).The results of Logistic regression showed a strong positive and independent relationship between HbA1c and subclinical atherosclerosis(OR=1.436,95%CI:1.160-1.777).Conclusion HbA1c is an independent risk factor for PLT,PM and subclinical atherosclerosis in non-diabetic overweight and obese subjects.