在患有糖尿病的心血管疾病患者中,HbA1c和全因死亡率之间的U形关联
Jianhong Yu1, Haodong Hua1, Minggang Yin2
1Department of Clinical Laboratory, Zigong First People's Hospital, Zigong, China.
Scientific reports
|November 17, 2024
概括
糖化血红蛋白 (HbA1c) 显示出 U 形与心血管疾病糖尿病患者死亡率的联系. 最佳的血糖控制,大约6.9%,可以降低所有原因的死亡风险.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 心血管疾病 (CVD) 和糖尿病是全球死亡的主要原因.
- 通过糖化血红蛋白 (HbA1c) 测量的血糖控制对于管理糖尿病至关重要.
- 糖尿病心血管疾病患者的HbA1c水平与死亡风险之间的关系需要进一步阐明.
研究的目的:
- 研究糖尿病和心血管疾病患者的基线糖化血红蛋白 (HbA1c) 水平和全因死亡率之间的关联.
- 要确定这个关联是线性的还是非线性的.
- 确定一个最佳的HbA1c目标,以减少高风险人群的死亡率.
主要方法:
- 从国家健康和营养检查调查 (NHANES) 1999-2014年的数据分析.
- 包括845名患有心血管疾病的糖尿病患者,随访时间平均为7.3年.
- 应用多变量Cox比例危险模型,限制立方线,以评估HbA1c和全因死亡率之间的非线性关联.
主要成果:
- 在HbA1c水平和全因死亡率之间观察到U形关系.
- 作为连续变量,HbA1c与死亡率没有显著关联.
- 与水平低于6.2%的患者相比,HbA1c水平在6.2-7.6%之间的患者死亡风险降低. 确定了6.9%的最佳HbA1c目标.
结论:
- 在患有心血管疾病的糖尿病患者中,HbA1c和全因死亡率之间的关联是非线性和U形的.
- 约6.9%的HbA1c目标可能与最低的死亡风险有关.
- 建议对这种患者群体进行血糖控制策略的个性化,以优化结果.
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