糖化白蛋白、糖化血红蛋白与糖尿病微血管病变的关系及临床意义

Relationship and clinical significance of glycated albumin,glycosylated hemoglobin and diabetic microangiopathy

目的探讨糖化白蛋白(glycosylated albumin,GA)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)在糖尿病微血管病变(microvascular complications of diabetes,MVCD)患者中的表达及临床意义。方法选择辽宁省朝阳市中心医院2017年5月至2019年7月收治的2型糖尿病患者共计295例作为病例组,根据患者是否发生微血管病变分为单纯糖尿病组(217)和微血管病变组(78)。选择同期健康查体者200例作为正常对照组。比较病例组和正常对照组GA、HbA1c水平,并进行单纯糖尿病组和微血管病变组GA、HbA1c水平的比较,采用Logistic回归分析法分析2型糖尿病患者发生微血管病变的危险因素。结果病例组患者GA、HbA1c分别为(23.9±10.1)%、(8.6±2.3)%,正常对照组分别为(13.4±1.2)%、(5.0±0.6),两组比较差异均有统计学意义(t值分别为14.628、21.636,P均<0.01)。单纯糖尿病组患者GA、HbA1c分别为(22.8±9.7)%、(8.4±2.0)%,微血管病变组分别为(25.4±10.3)%、(9.2±2.4)%,两组比较差异均有统计学意义(t值分别为1.997、2.869,P值分别为0.047、0.004)。Logistic回归分析结果表明,GA、HbA1c为2型糖尿病患者发生微血管病变的危险因素[OR(95%CI)值分别为1.088(1.030~1.157)、15.251(1.756~131.157),P值分别为0.003、0.014]。结论MVCD的发生与GA、HbA1c有关。Logistic回归分析结果表明,GA、HbA1c水平为MVCD发生的危险因素,可作为MVCD发生的预测因素。

Objective To investigate the expression and clinical significance of glycosylated albumin(GA)and glycosylated hemoglobin(HbA1c)in patients with diabetic microangiopathy(MVCD).Methods A total of 295 patients with type 2 diabetes admitted to Chaoyang Central Hospital of Liaoning Province from May 2017 to July 2019 were selected as case group,and they were divided into simple diabetes group(217)and microvascular disease group(78)according to whether the patients had microvascular lesions.Two hundred healthy people were selected as normal control group.The levels of GA and HbA1c were compared between the case group and the normal control group,and the levels of GA and HbA1c in the diabetic group and the microvascular disease group were compared.The risk factors of microangiopathy in patients with type 2 diabetes mellitus were analyzed by logistic regression analysis.Results The levels of GA and HbA1c were(23.9±10.1)%and(8.6±2.3)%in the case group,which were(13.4±1.2)%and(5.0±0.6)%in the normal control group.The differences between the two groups were statistically significant(t=14.628,21.636,all P<0.01).The levels of GA and HbA1c were(22.8±9.7)%and(8.4±2.0)%in the simple diabetes group and(25.4±10.3)%and(9.2±2.4)%in the microvascular disease group.The differences between the two groups were statistically significant(t=1.997,2.869,P=0.047,0.004).Logistic regression analysis showed that GA and HbAlc were risk factors for microangiopathy in patients with type 2 diabetes(OR(95%CI)values were 1.088(1.030-1.157)and 15.251(1.756-131.157),P=0.003 and 0.014).Conclusion The occurrence of MVCD is related to GA and HbA1c.Logistic regression analysis showed that GA and HbA1c levels were risk factors of MVCD,and could be used as predictive factors of MVCD.