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目的分析社区2型糖尿病人群中糖化血红蛋白和颈动脉斑块危险性的关系。方法在社区人群中进行横断面调查,经统一问卷调查获得人口学、行为生活方式、疾病史、用药史等信息,并进行糖化血红蛋白检测及颈动脉超声检查。纳入自报有医生明确诊断的糖尿病患者或正在服用降糖药或胰岛素者,年龄≥40岁,共552例。通过单因素和多因素Logistic回归,分析糖化血红蛋白含量与颈动脉斑块相关性,进行分层分析,研究不同特征人群的糖化血红蛋白与颈动脉斑块相关性的差异。结果纳入的2型糖尿病患者(男218例,女334例)中,颈动脉斑块检出率为41.9%,糖化血红蛋白平均浓度为(7.25±1.53)%。单因素Logistic回归分析中,糖化血红蛋白浓度每升高一个单位,颈动脉斑块危险度的比值比为1.10(95%CI 0.98~1.22,P=0.108),调整了年龄和性别因素后的比值比为1.13(95%CI 1.00~1.26,P=0.047),当调整疾病史、吸烟、饮酒、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、体重指数(body mass index,BMI)、休闲体育锻炼等级、药物服用情况、睡眠时间、卒中家族史后,多因素Logistic回归模型显示,糖化血红蛋白浓度每升高一个单位,颈动脉斑块危险度的比值比为1.16(95%CI 1.02~1.33,P=0.025)。对糖化血红蛋白浓度进行分类处理后,高水平组是低水平组颈动脉斑块检出危险性的1.71倍(95%CI 1.06~2.76,P=0.028),中水平组是低水平组危险性的1.40倍(95%CI 0.87~2.25,P=0.170)。分层分析结果显示,年龄<60岁组、BMI≥24kg/m~2组、伴发高血压组中糖化血红蛋白浓度和颈动脉斑块危险性具有相关性。结论在社区2型糖尿病人群中,糖化血红蛋白浓度与颈动脉斑块检出呈现相关关系。
Objective To analyze the relationship between glycated hemoglobin and carotid plaque risk in community type 2 diabetes mellitus. Methods Cross-sectional surveys were conducted in community population. Demographic, behavioral and lifestyle, disease history, medication history and other information were obtained through a unified questionnaire survey. HbA1c and carotid ultrasonography were also performed. Patients enrolled in a diabetes mellitus diagnosed with a definite diagnosis by a doctor or taking hypoglycemic agents or insulin, 552 patients ≥40 years of age. The relationship between HbA1c and carotid artery plaque was analyzed by single factor and multivariate Logistic regression, and stratified analysis was carried out to study the correlation between HbA1c and carotid plaque in different characteristics. Results The detection rate of carotid plaques was 41.9% in patients with type 2 diabetes mellitus (male 218, female 334), and the average HbA 1c level was (7.25 ± 1.53)%. In the univariate Logistic regression analysis, the odds ratio of carotid plaque risk was 1.10 (95% CI 0.98 to 1.22, P = 0.108) for each unit of HbA1c increase, adjusted for odds ratios after age and gender Was 1.13 (95% CI 1.00-1.26, P = 0.047). When adjusting for disease history, smoking, drinking, total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, body mass index Multivariate Logistic regression model showed that the ratio of carotid plaque risk was 1.16 (95% confidence interval) for every unit increase in HbA 1c, physical activity status, sleep duration, family history of stroke, CI 1.02 ~ 1.33, P = 0.025). The classification of glycosylated hemoglobin, high-level group was 1.71 times (95% CI 1.06 ~ 2.76, P = 0.028) risk of detection of carotid plaque in low-level group, the middle-level group was low risk 1.40-fold (95% CI 0.87-2.25, P = 0.170). Hierarchical analysis showed that age <60-year-old group, BMI ≥ 24kg / m ~ 2 group with concomitant hypertension group glycosylated hemoglobin concentration and carotid plaque risk associated. Conclusion In patients with type 2 diabetes mellitus, the concentration of HbA1c is correlated with carotid plaque detection.