The relationship between dysglycemia and atherosclerosis in South Asian, Chinese, and European individuals in Canada - A randomly sampled cross-sectional study
The relationship between dysglycemia and atherosclerosis in South Asian, Chinese, and European individuals in Canada - A randomly sampled cross-sectional study
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DOI：
10.2337/diacare.26.1.144
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发表时间：
2003-01-01
期刊：
影响因子：
16.2
通讯作者：
Yusuf, S
中科院分区：
文献类型：
--
作者：
Gerstein, HC;Anand, S;Yusuf, S
目的：血糖水平从正常水平升高到糖尿病范围（血糖异常）是临床心血管事件的一个新的危险因素。研究设计和方法-葡萄糖耐量，HbA（1c），AS的其他代谢危险因素，和颈动脉平均最大内膜中层厚度在979名加拿大人的随机样本中进行了评估，包括南亚人，中国人，结果：所有受试者中，HbA（1c）每增加0.9%，年龄和性别调整后的内膜中层厚度增加0.026 mm南亚人（P = 0.018）、中国人（P = 0.002）和欧洲人（P < 0.0001）的基因型差异有统计学意义。当HbA（1c）水平> 5.7%时，这种渐进曲线关系最为明显。在调整种族、年龄、性别、糖尿病状态、腹型肥胖、胰岛素抵抗、胰岛素分泌、空腹游离脂肪酸、血压和/或血脂异常后，HbA 1c与AS的关系仍然存在（P < 0.004）。糖尿病（P = 0.002）和HbA（1c）（P < 0.0001）是内膜中层厚度的决定因素。当在一个单一的模型中，HbA 1c（P < 0.0001），而不是糖尿病（P = 0.6）是一个重要的决定因素。结论-AS的程度与HbA 1c水平有关，与糖尿病状态无关，与腹部肥胖和代谢综合征的其他标志物无关。HbA（1c）和AS之间的这种进展关系在不同的种族群体中观察到。
OBJECTIVE - Raised glucose levels extending from normal into the diabetic range (dysglycemia) are an emerging risk factor for clinical cardiovascular events. The relationship between dysglycemia and atherosclerosis (AS) in the general population and in different ethnic groups remains controversial.RESEARCH DESIGN AND METHODS - Glucose tolerance, HbA(1c), other metabolic risk factors for AS, and carotid mean maximal intimal media thickness were assessed in a random sample of 979 Canadians of South Asian, Chinese, and European descent.RESULTS - The age and sex-adjusted intimal medial thickness increased 0.026 mm for every 0.9% increase in HbA(1c) in all participants (P < 0.0001) and in those of South Asian (P = 0.018), Chinese (P = 0.002), and European (P < 0.0001) descent. This progressive curvilinear relationship was most apparent at HbA(1c) levels >5.7%. The HbA(1c)-AS relationship persisted after adjustment for ethnicity, age, sex, diabetes Status, abdominal obesity, insulin resistance, insulin secretion, fasting free fatty acids, blood pressure, and/or dyslipidemia (P < 0.004). Both diabetes (P = 0.002) and HbA(1c) (P < 0.0001) were determinants of the intimal medial thickness when included in separate statistical models. When included together in a single model, HbA(1c) (P < 0.0001) but not diabetes (P = 0.6) was a significant determinant.CONCLUSIONS - The degree of AS is related to the level of HbA(1c) irrespective of diabetes status and independent of abdominal obesity and other markers of the metabolic syndrome. This progressive relationship between HbA(1c) and AS was observed within different ethnic groups.