Glycated Hemoglobin A1c, Fasting Plasma Glucose, and Two-Hour Postchallenge Plasma Glucose Levels in Relation to Carotid Intima-Media Thickness in Chinese with Normal Glucose Tolerance
Glycated Hemoglobin A1c, Fasting Plasma Glucose, and Two-Hour Postchallenge Plasma Glucose Levels in Relation to Carotid Intima-Media Thickness in Chinese with Normal Glucose Tolerance
复制标题
DOI：
10.1210/jc.2010-2697
复制
发表时间：
2011-09-01
影响因子：
5.8
通讯作者：
Ning, Guang
中科院分区：
文献类型：
--
作者：
Huang, Yun;Bi, Yufang;Ning, Guang
背景：在非糖尿病受试者中，高血糖标志物与心血管风险之间的相关性并不一致。关于正常葡萄糖耐量（NGT）受试者中相关性的数据更少。目的：我们的目的是评估NGT受试者糖化血红蛋白A1 c（HbA 1c）、空腹血糖（FPG）和2小时后血糖与颈动脉内膜中层厚度（CIMT）的相关性。设计、参与者和测量：本研究以上海市宝山区松南社区为研究对象，随机抽取40岁以上NGT患者1627名。所有参与者均接受75 g口服葡萄糖耐量试验、血液HbA 1c测定和CIMT测量。结果：采用多变量线性回归，在调整年龄、性别、吸烟和饮酒状况、体重指数、血压和血脂后，发现CIMT的增加趋势在HbA 1c四分位数（P = 0.016）中，而不是在FPG和激发后葡萄糖四分位数中。此外，在一个包括FPG和挑战后血糖作为协变量的完全校正的logistic模型中，与最低四分位数的参与者相比，HbA 1c最高四分位数的参与者仍使CIMT升高的几率增加68（>= 0.70 mm）。在NGT人群中，HbA 1c与CIMT显著相关，与传统心血管风险因素FPG无关，和激发后葡萄糖。结果表明，HbA 1c可能比FPG和NGT受试者的挑战后血糖更能提供心血管风险的信息。（临床内分泌代谢杂志96：E1461-E1465，2011）
Context: The association between hyperglycemic markers and cardiovascular risk is not consistent in nondiabetic subjects. Even less are the data regarding the associations in subjects with normal glucose tolerance (NGT).Objective: Our objective was to assess the association of glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and 2-h postchallenge glucose with carotid intima-media thickness (CIMT) in subjects with NGT.Design, participants and measurements: This cross-sectional study included 1627 participants with NGT and aged 40 yr and above, who were randomly recruited from Songnan Community, Baoshan District, Shanghai. All participants received a 75-g oral glucose tolerance test, blood HbA1c assay, and CIMT measurements.Results: Using multivariable linear regression, after adjustment for age, sex, smoking and drinking status, body mass index, blood pressure, and serum lipids, the increasing trend of CIMT was found in HbA1c quartiles (P = 0.016) rather than in FPG and postchallenge glucose quartiles. Furthermore, in a fully adjusted logistic model including FPG and postchallenge glucose as covariates, participants in the highest quartile of HbA1c, as compared with those in the lowest quartile, still conferred a 68% increased odds of elevated CIMT (>= 0.70 mm).Conclusions: In the population of NGT, HbA1c is significantly associated with CIMT independent of conventional cardiovascular risk factors, FPG, and postchallenge glucose. The results implied that HbA1c could be more informative of cardiovascular risk as compared with FPG and postchallenge glucose in subjects with NGT. (J Clin Endocrinol Metab 96: E1461-E1465, 2011)