血红蛋白糖化指数对 2 型糖尿病患者心血管和微血管并发症及死亡率风险的重要性。

IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrinology and Metabolism Pub Date : 2024-10-01 Epub Date: 2024-10-15 DOI:10.3803/EnM.2024.2001
Claudia Regina Lopes Cardoso, Nathalie Carvalho Leite, Gil Fernando Salles
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引用次数: 0

摘要

研究背景本研究调查了血红蛋白糖化指数(HGI)对 2 型糖尿病队列中大血管和微血管结局、死亡率和低血糖发生率的预后重要性,并将其与糖化血红蛋白(HbA1c)进行了比较:方法: 对 687 名 2 型糖尿病患者(中位数随访 10.6 年)的基线和第一年平均 HGI 和 HbA1c 及其变异性进行了评估。采用多变量 Cox 回归评估 HGI 和 HbA1c 参数与大血管(总和主要心血管事件)和微血管结局(微量白蛋白尿、晚期肾衰竭、视网膜病变和周围神经病变)、死亡率(全因和心血管)以及中度/严重低血糖发生率的关系:在随访期间,共发生了 215 起心血管事件(176 起主要事件)和 269 起全因死亡事件(131 起心血管事件)。126名患者出现微量白蛋白尿,104名出现肾功能衰竭,161名出现视网膜病变,177名出现神经病变。共发生 90 次低血糖。除微量白蛋白尿和低血糖外,HGI 和 HbA1c 均可预测所有不良后果。它们对所有结果的调整风险大致相同。例如,第一年平均 HGI 的调整后危险比 (HRs) 及 95% 置信区间 (CIs)(按 1 个标准差增量估算)分别为 1.23(1.05 至 1.44)、1.20(1.03 至 1.38)、1.36(1.11 至 1.67)、1.28(1.09 至 1.67)和 1.29(1.09 至 1.54)。而平均 HbA1c 的 HRs(95% CIs)分别为 1.31(1.12 至 1.53)、1.28(1.11 至 1.48)、1.36(1.11 至 1.67)、1.33(1.14 至 1.55)和 1.29(1.09 至 1.53):在预测 2 型糖尿病患者的不良后果方面,HGI 不比 HbA1c 更好,目前还不能建议临床使用 HGI。
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Importance of the Hemoglobin Glycation Index for Risk of Cardiovascular and Microvascular Complications and Mortality in Individuals with Type 2 Diabetes.

Backgruound: This study investigated the prognostic importance of the hemoglobin glycation index (HGI) for macrovascular and microvascular outcomes, mortality, and hypoglycemia occurrence in a type 2 diabetes cohort and compared it to glycated hemoglobin (HbA1c).

Methods: Baseline and mean first-year HGI and HbA1c, and the variability thereof, were assessed in 687 individuals with type 2 diabetes (median follow-up, 10.6 years). Multivariable Cox regression was conducted to evaluate the associations of HGI and HbA1c parameters with macrovascular (total and major cardiovascular events) and microvascular outcomes (microalbuminuria, advanced renal failure, retinopathy, and peripheral neuropathy), mortality (all-cause and cardiovascular), and moderate/severe hypoglycemia occurrence.

Results: During follow-up, there were 215 total cardiovascular events (176 major) and 269 all-cause deaths (131 cardiovascular). Microalbuminuria developed in 126 patients, renal failure in 104, retinopathy in 161, and neuropathy in 177. There were 90 hypoglycemia episodes. Both HGI and HbA1c predicted all adverse outcomes, except microalbuminuria and hypoglycemia. Their adjusted risks were roughly equivalent for all outcomes. For example, the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs), estimated for 1 standard deviation increments, of mean first-year HGI were 1.23 (1.05 to 1.44), 1.20 (1.03 to 1.38), 1.36 (1.11 to 1.67), 1.28 (1.09 to 1.67), and 1.29 (1.09 to 1.54), respectively, for cardiovascular events, all-cause mortality, renal failure, retinopathy, and neuropathy; whereas the respective HRs (95% CIs) of mean HbA1c were 1.31 (1.12 to 1.53), 1.28 (1.11 to 1.48), 1.36 (1.11 to 1.67), 1.33 (1.14 to 1.55), and 1.29 (1.09 to 1.53).

Conclusion: HGI was no better than HbA1c as a predictor of adverse outcomes in individuals with type 2 diabetes, and its clinical use cannot be currently advised.

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来源期刊
Endocrinology and Metabolism
Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.60
自引率
5.90%
发文量
145
审稿时长
24 weeks
期刊介绍: The aim of this journal is to set high standards of medical care by providing a forum for discussion for basic, clinical, and translational researchers and clinicians on new findings in the fields of endocrinology and metabolism. Endocrinology and Metabolism reports new findings and developments in all aspects of endocrinology and metabolism. The topics covered by this journal include bone and mineral metabolism, cytokines, developmental endocrinology, diagnostic endocrinology, endocrine research, dyslipidemia, endocrine regulation, genetic endocrinology, growth factors, hormone receptors, hormone action and regulation, management of endocrine diseases, clinical trials, epidemiology, molecular endocrinology, neuroendocrinology, neuropeptides, neurotransmitters, obesity, pediatric endocrinology, reproductive endocrinology, signal transduction, the anatomy and physiology of endocrine organs (i.e., the pituitary, thyroid, parathyroid, and adrenal glands, and the gonads), and endocrine diseases (diabetes, nutrition, osteoporosis, etc.).
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