糖化血红蛋白变异指数对2型糖尿病心血管并发症的预测价值

Predictive value of glycated hemoglobin variation index for cardiovascular complications in type 2 diabetes mellitus

目的探索糖化血红蛋白变异指数(HGI)对2型糖尿病(T2DM)心血管并发症的预测价值。方法在常熟市采用整群随机抽样方法抽取12个乡镇纳入国家基本公卫管理的T2DM患者进行调查,共调查到10 246例。采用三分位数法把HGI水平分为低、中、高3组,分析其与心血管并发症之间的关联。结果糖尿病患者中有心血管并发症患者1 215例(脑卒中695例,冠心病633例)。单因素分析显示,不同的HGI与心血管并发症,脑卒中有关(P <0.05),而HGI与冠心病无关(P> 0.05)。调整混杂因素后,多因素Logistic回归分析结果显示,与低HGI组相比,中HGI组、高HGI组更容易发生T2DM心血管并发症(OR值分别为1.200、1.276,P <0.05),高HGI组更容易发生脑卒中(OR=1.297,P <0.05),中HGI组更容易发生冠心病(OR=1.224,P <0.05)。结论 HGI可能是预测T2DM患者发生心血管并发症风险的指标之一。

Objective To explore the predictive value of haemoglobin glycation index( HGI) for cardiovascular complications in patients with type 2 diabetes( T2 DM). Methods A total of 10 246 patients with type 2 diabetes,who received national basic public health service in 12 counties of Changshu,were recruited by cluster sampling. According to the HGI value,all the subjects were divided into low HGI group,middle HGI group and high HGI group. The clinical data were compared among the three groups,and its association with cardiovascular complications was estimated. Results Among the diabetes patients,there were 1 215 patients with cardiovascular complications( 695 patients with stroke and 633 patients with coronary heart disease).Univariate analysis showed that HGI was significantly associated with T2 DM cardiovascular complications and stroke( P <0. 05). But no significant association of HGI with the risk of coronary heart disease was found( P > 0. 05). After adjusting for potential confounding factors,Logistic regression analysis showed that compared with low HGI group,middle and high HGI group both had a significantly increased risk of cardiovascular complications( OR: 1. 200,OR: 1. 276,P < 0. 05). And high HGI group had a significantly increased risk of stroke( OR = 1. 297,P < 0. 05). Middle HGI group had a significantly increased risk of coronary heart disease( OR = 1. 224,P < 0. 05). Conclusion HGI may be used as one of the risk predictor of cardiovascular complications in patients with T2 DM.