1.南京医科大学第一附属医院内分泌科，江苏 南京 210029 ;2.扬州大学医学院附属盐城妇幼保健院内分泌科，江苏 盐城 224000 ;3.全椒县人民医院内分泌科，安徽 全椒 239500
R587.1
国家自然科学基金（82370839）
1.Department of Endocrinology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029 ;2.Department of Endocrinology，the Affiliated Yancheng Maternity & Child Health Hospital of Yangzhou University Medical School，Yancheng 224000 ;3.Department of Endocrinology，Quanjiao County People’s Hospital，Quanjiao 239500 ，China
目的：探讨血红蛋白糖化指数（hemoglobin glycation index，HGI）与2型糖尿病（type 2 diabetes mellitus，T2DM）患者颈动脉内膜中层厚度（carotid intima-media thickness，cIMT）的关系。方法：选取在扬州大学医学院附属盐城市妇幼保健院住院的T2DM患者302例，检测患者cIMT、空腹血糖（fasting plasma glucose，FPG）、糖化血红蛋白（glycated hemoglobin A1c，HbA1c） 水平。根据HbA1c和FPG计算HGI，高HGI定义为HGI≥0，低HGI定义为HGI<0。观察患者cIMT与HGI的关系。结果：302例 T2DM患者中cIMT增厚者140例（46.4%）。cIMT增厚组高HGI比例较cIMT正常组高（36.4% vs. 22.8%，P < 0.05），病程、吸烟比例、高血压比例、收缩压（systolic blood pressure，SBP）、舒张压（diastolic blood pressure，DBP）、HbA1c、低密度脂蛋白胆固醇（low- density lipoprotein cholesterol，LDL-C）均较cIMT正常组高（P < 0.05），估算的肾小球滤过率（estimated glomerular filtration rate， eGFR）低于 cIMT 正常组（P < 0.05）。HbA1c、HGI 与 cIMT 呈正相关（r=0.257、0.399，P < 0.05），Logistic 回归分析显示 HGI 及 HbA1c均增加cIMT增厚的风险［OR=1.511（95%CI：1.237~1.846），OR=1.287（95%CI：1.053~1.571）］。结论：T2DM患者动脉粥样硬化患病率较高，HGI可能是HbA1c以外的T2DM患者动脉粥样硬化风险的新指标。
Objective：To explore the relationship between hemoglobin glycation index（HGI）and carotid intima -media thickness （cIMT）in patients with type 2 diabetes mellitus（T2DM）. Methods：A total of 302 T2DM patients admitted to the Affiliated Yancheng Maternity and Child Health Hospital of Yangzhou University Medical School were enrolled. The clinical parameters including cIMT， fasting plasma glucose（FPG），and glycated hemoglobin A1c（HbA1c）were measured. HGI was calculated based on HbA1c and FPG， with high HGI defined as HGI ≥ 0 and low HGI defined as HGI < 0. The relationship between cIMT and HGI was observed. Results： Among the 302 patients with T2DM，140 cases（46.4%）had thickened cIMT. The proportion of high HGI in the cIMT thickening group was higher than that in the normal cIMT group（36.4% vs. 22.8%，P < 0.05）. The cIMT thickening group also had longer duration of diabetes，higher smoking rate，hypertension rate，systolic blood pressure（SBP），diastolic blood pressure（DBP），HbA1c，and low-density lipoprotein cholesterol（LDL-C）levels compared to the normal cIMT group（P < 0.05）. The estimated glomerular filtration rate （eGFR）was lower in the cIMT thickening group（P < 0.05）. HbA1c and HGI were positively correlated with cIMT（r=0.257，0.399，P < 0.05）. Logistic regression analysis showed that both HGI and HbA1c increased the risk of cIMT thickening［OR =1.511（95% CI： 1.237-1.846），OR=1.287（95% CI：1.053-1.571）］. Conclusion：The prevalence of atherosclerosis is high in patients with T2DM，and HGI may be a new indicator of atherosclerosis risk in T2DM patients，beyond HbA1c.
张成洲,陈健,孟民,李文和,任明慧,李雅洁,徐宽枫,崔岱.血红蛋白糖化指数与2型糖尿病患者颈动脉内膜中层厚度的相关性研究[J].南京医科大学学报（自然科学版）,2025,(3):367-372
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