Study on the correlation between glycosylated hemoglobin and carotid intima-media thickness

doi:10.11958/20220321

Abstract

Abstract:

Objective To study the correlation between glycosylated hemoglobin (HbA1c) level and carotid intima-media thickness (CIMT) thickening in general physical examination population. Methods A total of 9 881 cases with general physical examination were selected as the research object, including 7 091 males and 2 790 females. CIMT was measured by vascular color Doppler ultrasound. According to whether there was CIMT thickening, the cases were divided into the thickening group (4 513 cases) and the normal group (5 368 cases). The general data and laboratory data of the two groups were collected and compared. Logistic regression was used to analyze the risk factors of CIMT thickening in the general population and different genders. Receiver operating characteristic curve (ROC) was used to evaluate the predictive effect of the HbA1c level on CIMT thickening. Results Compared to the normal group, male proportion, age, body mass index (BMI), systolic blood pressure (SBP), direct bilirubin (DBIL), globulin (GLB), blood urea nitrogen (BUN), blood creatinine (Scr), blood glucose (GLU), HbA1c, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels were increased in the thickening group. The glomerular filtration rate (eGFR), alanine aminotransferase (ALT), albumin (ALB) and high density lipoprotein cholesterol (HDL-C) were decreased (P<0.05). Logistic regression analysis showed that in the total population, advanced age, male, ALB, GLU and LDL-C increased, and HbA1c≥5.7% was risk factors for CIMT thickening, while increased GLB and HDL-C were protective factors for CIMT thickening. In males, advanced age, increased ALB and LDL-C, and HbA1c≥5.7% were risk factors for CIMT thickening, while increased ALT, GLB and HDL-C were protective factors for CIMT thickening. In females, increased SBP and TC and HbA1c≥5.6% were risk factors for CIMT thickening, while increased BMI, eGFR, ALB, Scr and HDL-C were protective factors for CIMT thickening. ROC curve analysis showed that the optimal cut-off value of HbA1c in predicting CIMT thickening was 5.65% in the total population, males and females, and HbA1c has better predictive efficiency for CIMT thickening in females. Conclusion The elevated HbA1c levels are a risk factor for CIMT thickening in the general population, and HbA1c has a greater effect on CIMT thickening in the females.

Key words: hemoglobin A, glycosylated, carotid arteries, regression analysis, carotid artery intima-media thickness, general population

CLC Number:

R543.4

Figures/Tables 6

References 22

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组别	n			性别（男/女）			年龄（岁）	BMI（kg/m²）			eGFR[mL/（min·1.73 m²）]				SBP（mmHg）			DBP（mmHg）			SUA（μmol/L）
正常组	5 368			3 571/1 797			51.00±13.51	24.68±3.27			108.64±21.11				127.84±17.59			75.18±11.72			357.24±90.90
增厚组	4 513			3 520/993			69.19±12.22	24.99±3.12			95.92±21.06				139.29±19.38			74.92±11.66			359.30±83.70
χ²、t或Z				159.267^＊＊			69.046^＊＊	4.725^＊＊			29.886^＊＊				30.688^＊＊			1.093			1.159
组别			ALT（U/L）			TBIL（μmol/L）			DBIL（μmol/L）			TP（g/L）		ALB（g/L）			GLB（g/L）			BUN（mmol/L）
正常组			25.23±18.50			13.91±5.68			3.45±1.52			74.83±4.49		45.35±2.84			29.47±3.82			4.84±1.20
增厚组			22.15±12.60			13.97±5.21			3.65±1.54			74.83±4.63		44.61±2.77			30.22±4.19			5.51±1.69
χ²、t或Z			9.496^＊＊			0.524			6.070^＊＊			0.088		13.101^＊＊			9.318^＊＊			23.040^＊＊
组别		Scr（μmol/L）			GLU（mmol/L）			HbA1c（%）		TC（mmol/L）			TG（mmol/L）			HDL-C（mmol/L）			LDL-C（mmol/L）
正常组		67.66±14.63			5.21±1.09			5.69±0.67		5.21±0.97			1.50（1.05,2.09）			1.39±0.34			3.00±0.81
增厚组		74.33±23.68			5.71±1.46			6.02±0.87		5.32±1.08			1.52（1.13,2.08）			1.31±0.33			3.18±0.94
χ²、t或Z		17.125^＊＊			19.644^＊＊			21.599^＊＊		5.515^＊＊			1.510			11.858^＊＊			9.896^＊＊

组别	n			性别（男/女）			年龄（岁）	BMI（kg/m²）			eGFR[mL/（min·1.73 m²）]				SBP（mmHg）			DBP（mmHg）			SUA（μmol/L）
正常组	5 368			3 571/1 797			51.00±13.51	24.68±3.27			108.64±21.11				127.84±17.59			75.18±11.72			357.24±90.90
增厚组	4 513			3 520/993			69.19±12.22	24.99±3.12			95.92±21.06				139.29±19.38			74.92±11.66			359.30±83.70
χ²、t或Z				159.267^＊＊			69.046^＊＊	4.725^＊＊			29.886^＊＊				30.688^＊＊			1.093			1.159
组别			ALT（U/L）			TBIL（μmol/L）			DBIL（μmol/L）			TP（g/L）		ALB（g/L）			GLB（g/L）			BUN（mmol/L）
正常组			25.23±18.50			13.91±5.68			3.45±1.52			74.83±4.49		45.35±2.84			29.47±3.82			4.84±1.20
增厚组			22.15±12.60			13.97±5.21			3.65±1.54			74.83±4.63		44.61±2.77			30.22±4.19			5.51±1.69
χ²、t或Z			9.496^＊＊			0.524			6.070^＊＊			0.088		13.101^＊＊			9.318^＊＊			23.040^＊＊
组别		Scr（μmol/L）			GLU（mmol/L）			HbA1c（%）		TC（mmol/L）			TG（mmol/L）			HDL-C（mmol/L）			LDL-C（mmol/L）
正常组		67.66±14.63			5.21±1.09			5.69±0.67		5.21±0.97			1.50（1.05,2.09）			1.39±0.34			3.00±0.81
增厚组		74.33±23.68			5.71±1.46			6.02±0.87		5.32±1.08			1.52（1.13,2.08）			1.31±0.33			3.18±0.94
χ²、t或Z		17.125^＊＊			19.644^＊＊			21.599^＊＊		5.515^＊＊			1.510			11.858^＊＊			9.896^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
性别	0.305	0.068	19.937	<0.001	1.357	1.115~1.518
年龄	0.108	0.003	1 646.525	<0.001	1.114	1.108~1.119
ALB	0.044	0.011	16.262	<0.001	1.045	1.023~1.068
GLB	-0.020	0.007	7.729	0.005	0.980	0.966~0.994
GLU	0.063	0.031	4.222	0.040	1.065	1.003~1.132
HDL-C	-0.696	0.093	56.383	<0.001	0.498	0.416~0.598
LDL-C	0.240	0.032	55.419	<0.001	1.272	1.194~1.355
HbA1c	-	-	9.440	0.004	-	-
5.4%~<5.7%	0.151	0.085	0.207	0.080	1.163	0.982~1.378
5.7%~<6.0%	0.235	0.083	6.944	0.008	1.265	1.062~1.570
≥6.0%	0.322	0.106	16.609	<0.001	1.380	1.154~1.650
常量	-7.846	0.623	158.393	<0.001	0.000	-

变量	β	SE	Wald χ²	P	OR	OR 95%CI
性别	0.305	0.068	19.937	<0.001	1.357	1.115~1.518
年龄	0.108	0.003	1 646.525	<0.001	1.114	1.108~1.119
ALB	0.044	0.011	16.262	<0.001	1.045	1.023~1.068
GLB	-0.020	0.007	7.729	0.005	0.980	0.966~0.994
GLU	0.063	0.031	4.222	0.040	1.065	1.003~1.132
HDL-C	-0.696	0.093	56.383	<0.001	0.498	0.416~0.598
LDL-C	0.240	0.032	55.419	<0.001	1.272	1.194~1.355
HbA1c	-	-	9.440	0.004	-	-
5.4%~<5.7%	0.151	0.085	0.207	0.080	1.163	0.982~1.378
5.7%~<6.0%	0.235	0.083	6.944	0.008	1.265	1.062~1.570
≥6.0%	0.322	0.106	16.609	<0.001	1.380	1.154~1.650
常量	-7.846	0.623	158.393	<0.001	0.000	-

变量	β	SE	Wald χ²	P	OR	OR 95%CI
年龄	0.102	0.003	1 073.859	<0.001	1.108	1.101~1.115
ALT	-0.006	0.002	8.452	0.004	0.994	0.989~0.998
ALB	0.044	0.013	11.901	0.001	1.045	1.019~1.071
GLB	-0.020	0.008	5.302	0.021	0.981	0.964~0.997
HDL-C	-0.815	0.115	50.522	<0.001	0.443	0.354~0.554
LDL-C	0.283	0.038	56.143	<0.001	1.328	1.233~1.430
HbA1c	-	-	9.908	0.003	-	-
5.4%~<5.7%	0.191	0.100	0.013	0.050	1.210	1.000~1.464
5.7%~<6.0%	0.270	0.094	10.560	0.008	1.310	1.074~1.599
≥6.0%	0.370	0.093	16.187	<0.001	1.448	1.187~1.768
常量	-7.399	0.707	109.439	<0.001	0.001	-