通过HbA1c而不是空腹血葡萄糖评估的血糖变异性与不良心血管事件有关
Lijuan Sheng1, Guifang Yang2,3,4, Xiangping Chai2,3,4
1Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China.
Frontiers in endocrinology
|February 29, 2024
概括
增加的血红蛋白A1c (HbA1c) 变异性,而不是空腹血葡萄糖 (FPG) 变异性,与2型糖尿病的主要不良心血管事件 (MACE) 有关. 密集的血糖控制可能会加剧这种关联.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
背景情况:
- 血糖的变化与心血管疾病风险有关.
- 很少有研究比较HbA1c和FPG在2型糖尿病 (T2DM) 中心血管事件的变化.
研究的目的:
- 研究T2DM患者的HbA1c和FPG变异性与主要心血管不良事件 (MACE) 之间的关联.
- 探索血糖控制策略对这种关系的影响.
主要方法:
- 对ACCORD研究进行了后期分析.
- 用于评估HbA1c/FPG可变性和MACE发病率的Cox比例危险模型.
- 分析包括9547名T2DM患者,随访时间中位数为4.6年.
主要成果:
- 较高的HbA1c可变性四分位数显示MACE风险显著增加 (第四个四分位数中的HR为1.37).
- FPG的变化与MACE没有显著的关联 (P为趋势=0.28).
- 在血糖变化和MACE之间观察到U形关系;密集的葡萄糖控制放大了MACE风险,HbA1c变化更高 (相互作用P<0.01).
结论:
- 在T2DM中,增加的HbA1c可变性,而不是FPG可变性,与MACEs有显著的关联.
- 血糖变化表现出与MACEs的U形关系.
- 血糖控制策略影响HbA1c变异性-MACEs联系,密集控制带来更高的风险.
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