体重指数对糖化血红蛋白及糖化白蛋白影响的研究

Study on the effect of body mass index on hemoglobin A1c and glycated albumin

目的分析BMI对HbA_(1)c及糖化白蛋白(GA)的影响。方法选取北京市平谷区代谢性疾病研究中3895名26~76岁常住居民数据。按FPG、2 hPG分层比较BMI各四分位数分组的HbA_(1)c、GA水平;采用多因素线性回归模型分析HbA_(1)c、GA的影响因素。结果调整年龄、性别、血红蛋白后,在4.0≤FPG<6.0 mmol/L(P<0.001)、6.0≤FPG<7.0 mmol/L(P=0.003)、7.0≤FPG<8.0 mmol/L(P=0.030)及所有2 hPG(P<0.001)分层中,HbA_(1)c随BMI四分位数升高呈递增趋势;在4.0≤FPG<6.0 mmol/L(P<0.001)、6.0≤FPG<7.0 mmol/L(P=0.032)、FPG≥8.0 mmol/L(P<0.001)、2.0≤2 hPG<6.0 mmol/L(P<0.001)、6.0≤2 hPG<8.0 mmol/L(P<0.001)和8.0≤2 hPG<10.0 mmol/L(P<0.001)时,GA随BMI四分位数升高呈递减趋势。多因素线性回归分析显示,BMI是HbA_(1)c、GA的影响因素(β=0.018、-0.094,R^(2)=0.723、0.696,P<0.01)。结论在普通人群中,调整血糖因素后,当FPG<8.0 mmol/L时,HbA_(1)c随BMI升高而增加,当2 hPG<10.0mmol/L时,GA随BMI升高而减少。

Objective The effects of BMI on HbA_(1)c and glycated albumin(GA) were analyzed.Methods Data of 3895 individuals aged 26 to 76 years from Pinggu Metabolic Disease Study were analyzed in the study.Based on fasting plasma glucose(FPG) and 2-hour plasma glucose(2 hPG) level stratification,the difference of HbA_(1)c and GA between BMI subgroups was compared.Multivariate linear regression model was used to analyze the influencing factors of HbA_(1)c and GA.Results After adjustment for age,sex and hemoglobin, BMI was positively associated with HbA_(1)c when 4≤FPG<6 mmol/L(P<0.001), 6≤FPG<7 mmol/L(P=0.003),7.0≤FPG<8 mmol/L(P=0.030) and all stratification of 2 hPG(P<0.001),while a significant inverse association was found between BMI and GA when 4.0≤FPG<6.0 mmol/L CP<0.001),6.0≤FPG<7.0 mmol/L(P=0.032),FPG≥8.0 mmol/L(P<0.001),2.0≤2 hPG<6.0 mmol/L(P<0.001),6.0≤2 hPG<8.0 mmol/L(P<0.001) and 8.0≤2 hPG<10.0 mmol/L(P<0.001).In multiple linear regression model,BMI is the influencing factor of HbA_(1)c and GA(β=0.018,-0.094,R^(2)=0.723,0.696,P<0.01).Conclusion In general population,when FPG<8.0 mmol/L,HbA_(1)c increased with BMI,while when 2 hPG<10.0 mmol/L,GA decreased with BMI.