CAJ | 학술논문

目的探讨相对健康的中老年人血中糖化血红蛋白(HbAlc)含量对颈动脉硬化的影响.方法从广州生物库队列中单纯随机抽样收集1863名年龄≥50岁的广州市居民的个人资料,问卷调查其病史、体格检查及测定血清空腹血糖、血脂、HbA1c的含量并应用彩色多普勒超声测量颈总动脉内膜-中层厚度(intima media thickness,IMT).在调整相关混染因素后,应用协方差分析进行连续变量分析.结果 (1)在调整年龄、性别和空腹血糖等因素后,平均颈总动脉IMT随HbA1c含量升高呈明显增加趋势(P=0.005).线性回归模型显示,在调整年龄、性别、吸烟状态、腰围、收缩压和舒张压、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和空腹血糖等潜在危险因素后,结果仍然显示HbA1c水平与平均颈总动脉IMT有明显的线性相关(回归系数为0.014,P=0.03);(2)经过调整多种潜在混杂因素后,与HbA1c理想组(HbA1c<6.5%)比较,良好组(HbA1c为6.5%～7.5%)和差组(HbA1c>7.5%)发生颈动脉硬化的比值比(95%置信区间)分别为1.62(1.10,2.38)和1.76(0.86,3.63),趋势检验(P=0.01).结论相对健康的中老年人HbA1c含量升高是颈动脉硬化的独立危险因素之一,提示降低HbA1c水平对阻止或延缓颈动脉硬化的发生与发展有重要意义.
목적 탐토상대건강적중노년인혈중당화혈홍단백(HbAlc)함량대경동맥경화적영향.방법 종엄주생물고대렬중단순수궤추양수집1863명년령≥50세적엄주시거민적개인자료,문권조사기병사、체격검사급측정혈청공복혈당、혈지、HbA1c적함량병응용채색다보륵초성측량경총동맥내막-중층후도(intima media thickness,IMT).재조정상관혼염인소후,응용협방차분석진행련속변량분석.결과 (1)재조정년령、성별화공복혈당등인소후,평균경총동맥IMT수HbA1c함량승고정명현증가추세(P=0.005).선성회귀모형현시,재조정년령、성별、흡연상태、요위、수축압화서장압、감유삼지、고밀도지단백담고순、저밀도지단백담고순화공복혈당등잠재위험인소후,결과잉연현시HbA1c수평여평균경총동맥IMT유명현적선성상관(회귀계수위0.014,P=0.03);(2)경과조정다충잠재혼잡인소후,여HbA1c이상조(HbA1c<6.5%)비교,량호조(HbA1c위6.5%～7.5%)화차조(HbA1c>7.5%)발생경동맥경화적비치비(95%치신구간)분별위1.62(1.10,2.38)화1.76(0.86,3.63),추세검험(P=0.01).결론 상대건강적중노년인HbA1c함량승고시경동맥경화적독립위험인소지일,제시강저HbA1c수평대조지혹연완경동맥경화적발생여발전유중요의의.
Objective To investigate the effect of glycosylated hemoglobin A1c(HbA1c) on carotid atheresclerosis in relatively healthy elderly Chinese people.Methods A total of 1863 relatively healthy Chinese people(≥50 years old)were randomized enrolled from the Guangzhou Biobank Cohort Study(GBCS).Personal general historiy Was collected before the study in all object.The blood pressure,fasting glucose,lipids,HbA1c and common carotid artery intima-median thickness(CCA-IMT)were measured respectively.After adjustment relevant confounding factors,analysis of convariance was used for continuous variable analysis.Results (1)Ater adjusting for age,sex and fasting glucose,mean CCA-IMT were increased significantly with the increase of HbA1c level in all participant(P=0.005).The results of linear regression models show that, HbA1c levels was positively associated with mean CCA-IMT after adjusting for age,sex,smoking,physical activity,waist circumference,systolic and diastolic blood pressure,triglyceride,hish-density,low-density lipoprotein cholesterol and fasting glucose(regression coefficient t=0.014,P=0.03).Compared to the optimal group(HbA1c<6.5%),adjusted odds ratios (95% confidence interval)for carotid atherosclerosis in the satisfactory group(HbA1c 6.5%-7.5%)and unsatisfactory group(HbA1c>7.5%)were 1.62(1.10,2.38)and 1.76(0.86,3.63)respectively(P for trend=0.01).Conclusions Increasing HbA1c level is an independent risk factor for carotid athemsclerosis;that HbA1c-lowering treatment may be an important means for preventing the progression of carotid atherosclerosis.