访问到访问的HbA1c变化与2型糖尿病患者的大动脉硬性进展有关
Qianhua Fang1,2, Juan Shi1,2, Jia Zhang1,2
1Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Cardiovascular diabetology
|July 6, 2023
概括
用HbA1c测量的长期访问到访问的血糖变化与2型糖尿病中大动脉硬度的进展有关. 这一发现突显了血糖变异性作为亚临床动脉样硬化的关键预测因素.
科学领域:
- 心血管医学 心血管医学
- 内分泌学 在内分泌学.
- 代谢综合征是代谢综合征的一种.
背景情况:
- 血糖的变化与心血管疾病 (CVD) 的发展有关.
- 大动脉硬是亚临床动脉样硬化的标志物,也是心血管疾病事件的预测因素.
- 了解血糖变化和大动脉硬之间的联系对于管理2型糖尿病 (T2D) 中心血管疾病风险至关重要.
研究的目的:
- 为了研究长期访问到访问的血糖变化和大动脉硬度进展之间的关联.
- 确定特定的血糖变化指标,预测T2D患者的大动脉硬.
- 确定血糖变化是否是大动脉硬度进展的独立预测因素.
主要方法:
- 对2115名T2D参与者的前性队列研究,平均随访时间为2.6年.
- 使用腕脉冲波速度 (ba-PWV) 测量评估的大动脉硬度.
- 使用HbA1c和空腹血糖 (FBG) 数据分析的血糖变化率,包括变化系数 (CV),独立于平均值的变化率 (VIM) 和平均真实变化率 (ARV) 等指标.
- 多变体潜伏类增长混合模型和后勤回归用于识别血糖轨迹并评估与大动脉硬性的关联.
主要成果:
- 确定了四种不同的血糖轨迹 (HbA1c/FBG).
- 一个U形的HbA1c/FBG轨迹与大动脉硬度进展的几率增加有关 (ORs 2.17和1.21).
- HbA1c变化指标 (CV,VIM,SV) 与大动脉硬度的进展显著相关 (ORs 1.20-1.24).
- 在第三层中较高的HbA1c平均值和VIM显示,大动脉硬度进展的几率提高了78%.
- HbA1c变化 (SD,HVS) 预测了不良结果,独立于平均HbA1c.
结论:
- 长期访问到访问的HbA1c变异性是T2D中大动脉硬度进展的独立预测因素.
- 血糖变化是2型糖尿病患者亚临床动脉样硬化的一个重要标志.
- 监测血糖变化可能有助于对T2D患者心血管疾病风险进行分层.
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