基于限制性立方样条模型分析糖化血红蛋白指数与颈动脉粥样硬化的关系

Relationship between the hemoglobin glycation index and carotid atherosclerosis based on restricted cubic spline model

    摘要
  • 摘要:
    目的 探讨糖化血红蛋白指数（HGI）与颈动脉粥样硬化（CAS）的关系，为CAS防控提供参考依据。
    方法 本研究以2020年1月至2024年12月于西南医科大学附属中医医院体检中心的成人为研究对象。收集其一般资料、体格检查、实验室指标及颈动脉超声检查结果。根据颈动脉超声检查结果分为CAS组（953例）及非CAS组1 229例，共2 182人，平均年龄（52.29±10.11）岁，男性占比88.7%，比较两组间的差异。根据糖化血红蛋白（HbA1c）及空腹血糖计算HGI，并根据HGI三分位数分为3组（T1、T2、T3）。应用logistic回归模型及限制性立方样条分析探讨HGI与CAS之间的关系。
    结果 CAS组HGI水平高于非CAS组（P＜0.001）。T3组呈现更明显的代谢异常及炎症水平，表现为高血压、糖尿病比例更高，白细胞计数、中性粒细胞、淋巴细胞、单核细胞、HbA1c水平最高（P＜0.001）。T3组中CAS的比例更高（T1：37.8%比T2：39.6%比T3：53.6%，χ2 = 44.421，P＜0.001）。调整混杂因素后，logistic回归分析结果显示，HGI T3组CAS风险是T1组的1.525倍（OR = 1.525 ，95%CI：1.213～1.916，P＜0.001）。限制性立方样条结果显示，HGI与CAS之间存在非线性剂量-反应关系（P总体 = 0.001，P非线性 = 0.025）。按性别进行分层后，无论在女性还是男性中，HGI与CAS之间均存在非线性剂量-反应关系（女性：P总体 = 0.002，P非线性 = 0.001；男性：P总体 ＜0.001，P非线性 = 0.001）。
    结论 HGI与CAS患病独立相关，并呈现非线性剂量-反应关系。

     

    Abstract:
    Objective  To explore the correlation between the hemoglobin glycation index (HGI) and carotid atherosclerosis (CAS), and provide a reference basis for the prevention and control of CAS.
    Methods Adults who underwent physical examinations at the Health Management Center of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University between January 2020 to December 2024 were selected as study participants. Baseline data, physical examination, laboratory indicators and carotid ultrasound examination results were collected. Participants were divided into carotid atherosclerosis group and no carotid atherosclerosis group based on carotid ultrasound examination results. Baseline data and laboratory indicators between the two groups were compared. HGI was calculated based on HbA1c and FPG, and the HGI was categorized according to terciles (T1, T2, T3), with T1 as the reference. A total of 2 182 subjects were included in the analysis, with an average age of (52.29±10.11) years old, and males accounted for 88.7%. Logistic regression model combined with restricted cubic spline model were recruited to explore the relationship between HGI and CAS.
    Resultss  The CAS group showed a higher level of HGI than the non-CAS group (P＜0.001). Group T3 exhibited more pronounced metabolic abnormalities and inflammatory levels, including a higher percentage of hypertension, diabetes, a higher level of white blood cell count, neutrophil count, lymphocyte count, monocyte count, and HbA1c concentration. Participants in the highest tertile of HGI had the largest percentage of people with CAS (T1 37.8% vs T2 39.6% vs T3 53.6%, χ2=44.421, P＜0.001). After adjusting for confounding factors, the results of logistic regression analysis showed that the risk of CAS in the HGI T3 group was 1.494 times higher than that in the T1 group (OR = 1.525, 95%CI: 1.213 to 1.916, P＜0.001). Restricted cubic spline model results showed a nonlinear dose-response relationship belween HGI and the risk of CAS in total population ( P for overall＜0.001. P for nonlinear = 0.025). Gender stratification analysis showed that a nonlinear dose-response relationship between HGI and the risk of CAS both in females and males ( females: P for overall = 0.002, P for nonlinear = 0.001; males: P for overall＜0.001, P for nonlinear = 0.001).
    Conclusion HGI is independently associated with CAS and exhibits a nonlinear dose-response relationship.

     

    • HTML全文
    • 参考文献(31)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回