GHb is a better predictor at cardiovascular disease than fasting or postchallenge plasma glucose in women without diabetes - The Rancho Bernardo Study
GHb is a better predictor at cardiovascular disease than fasting or postchallenge plasma glucose in women without diabetes - The Rancho Bernardo Study
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DOI：
10.2337/diacare.19.5.450
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发表时间：
1996-05-01
期刊：
影响因子：
16.2
通讯作者：
Edelstein, S
中科院分区：
文献类型：
--
作者：
Park, S;BarrettConnor, E;Edelstein, S
目的 - 研究老年人糖化血红蛋白（GHb）、空腹血糖（FPG）、餐后血糖（PCPG）与心血管疾病（CVD）和缺血性心脏病（IHD）死亡率之间的关系。
研究设计与方法 - 对1239名非糖尿病老年人进行了一项基于社区的研究，从基线（1984 - 1987年）到1993年平均随访8年。
结果 - 在女性而非男性中，糖化血红蛋白（GHb）与心血管疾病（CVD）和缺血性心脏病（IHD）死亡率显著相关，空腹血糖（FPG）和餐后血糖（PCPG）则无此相关性。糖化血红蛋白（GHb）处于最高五分位数（≥6.7%）的女性与较低水平者相比，经年龄调整后的心血管疾病死亡相对危险度为2.37（95%置信区间 = 1.30 - 4.31，P = 0.005），缺血性心脏病死亡相对危险度为2.43（95%置信区间 = 1.12 - 5.25，P = 0.024）。在对所有协变量（年龄、收缩压、体重指数、低密度脂蛋白、高密度脂蛋白、甘油三酯、吸烟、降压药使用和雌激素使用）进行调整后，这种相关性仍然存在。在女性中，糖化血红蛋白（GHb）与低密度脂蛋白和高密度脂蛋白水平显著相关，但在对这些脂蛋白进行调整后，糖化血红蛋白（GHb）与心血管疾病（CVD）或缺血性心脏病（IHD）之间的相关性仍然存在。
结论 - 我们得出结论，在无糖尿病的女性中，糖化血红蛋白（GHb）比空腹血糖（FPG）或餐后血糖（PCPG）更能预测心血管疾病（CVD）和缺血性心脏病（IHD）的死亡率，在男性中没有单一的血糖指标具有预测性。性别差异的原因尚不清楚。
OBJECTIVE - To examine the relation between GHb, fasting plasma glucose (FPG), post-challenge plasma glucose (PCPG), and mortality from cardiovascular disease (CVD) and ischemic heart disease (IHD) in older adults.RESEARCH DESIGN AND METHODS - A community-based study of 1,239 nondiabetic older adults followed for an average of 8 years, from baseline (1984-1987) to 1993.RESULTS - GHb, but not FPG or PCPG, was significantly related to CVD and IHD mortality in women but not men. The age-adjusted relative hazard for those in the highest quintile of GHb (greater than or equal to 6.7%) compared with women with lower levels was 2.37 for fatal CVD (95% CI = 1.30-4.31, P = 0.005) and 2.43 for IHD (95% CI = 1.12-5.25, P = 0.024). This association persisted after adjustment for all covariates (age, systolic blood pressure, BMI, LDL, HDL, triglicerides, cigarette smoking, antihypertensive medication use, and estrogen use). GHb was significantly associated with LDL and HDL levels in women, but the association between GHb and CVD or IHD persisted after adjustment for these lipoproteins.CONCLUSIONS - We conclude that GHb is a better predictor of CVD and IHD mortality than FPG or PCPG in women without diabetes, no single measure of glycemia was predictive in men. The reason for the sex difference is unexplained.