糖尿病患者血浆致动脉粥样硬化指数、甘油三酯血糖指数和血红蛋白 A1C 水平与冠状动脉钙化进展风险的不同关联。

IF 8.5 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Ki-Bum Won, Su-Yeon Choi, Eun Ju Chun, Sung Hak Park, Jidong Sung, Hae Ok Jung, Hyuk-Jae Chang
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引用次数: 0

摘要

背景:胰岛素抵抗和高血糖都是动脉粥样硬化的重要危险因素。虽然动脉粥样硬化的特征因糖尿病的不同而明显不同,但对于有糖尿病和无糖尿病情况下冠状动脉钙化(CAC)进展的风险与血浆致动脉粥样硬化指数(AIP)、甘油三酯血糖(TyG)指数和血红蛋白 A1C(HbA1C)等生物标志物的关系却知之甚少:我们对 12,326 名无症状的韩国成年人(平均年龄为 51.7 ± 8.5 岁;84.2% 为男性;15.8% 患有糖尿病)进行了分析,随访时间中位数为 3.0 年。AIP定义为甘油三酯浓度(毫摩尔/升)与高密度脂蛋白胆固醇(毫摩尔/升)之比的基10对数。TyG指数的计算公式为ln(空腹甘油三酯[mg/dL] × 空腹血糖[mg/dL]/2)。CAC进展采用SQRT法定义,即基线和随访冠状动脉钙化评分(CACS)的平方根(√)之差≥2.5(Δ√转换后的CACS)。采用调整扫描间期的逻辑回归模型估算几率比(OR):结果:糖尿病患者的 AIP、TyG 指数和 HbA1C 水平明显高于非糖尿病患者。糖尿病患者的 CAC 进展率(46.9%)高于非糖尿病患者(28.0%)。在对年龄、性别、高血压、高脂血症、肥胖、当前吸烟状况、血清肌酐水平、基线 CACS 和扫描间期进行调整后,只有非糖尿病患者的 AIP(每增加 0.1 个单位)与 CAC 进展相关(OR:1.04,95% 置信区间 [CI]:1.02 - 1.06;OR:1.02 - 1.06,95% 置信区间 [CI]:1.02 - 1.06):1.02 - 1.06;P 结论:AIP、TyG 指数和 HbA1C 水平与 CAC 进展之间的关系因糖尿病患者而异。在这些生物标志物中,TyG 指数与 CAC 进展独立相关,与已确诊的糖尿病无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Different associations of atherogenic index of plasma, triglyceride glucose index, and hemoglobin A1C levels with the risk of coronary artery calcification progression according to established diabetes.

Background: Both insulin resistance and hyperglycemia are important risk factors for atherosclerosis. While the characteristics of atherosclerosis are obviously different according to established diabetes, little has been known regarding the risk of coronary artery calcification (CAC) progression related to the biomarkers of atherogenic index of plasma (AIP), triglyceride glucose (TyG) index, and hemoglobin A1C (HbA1C) in conditions with and without diabetes.

Methods: We analyzed 12,326 asymptomatic Korean adults (mean age 51.7 ± 8.5 years; 84.2% males; 15.8% with diabetes) over a median follow-up period of 3.0 years. AIP was defined as the base-10 logarithm of the ratio of triglyceride concentration (mmol/L) to high-density lipoprotein cholesterol (mmol/L). The TyG index was calculated as ln (fasting triglycerides [mg/dL] × fasting glucose [mg/ dL]/2). CAC progression was defined using the SQRT method, as a difference of ≥ 2.5 between the square roots (√) of baseline and follow-up coronary artery calcium scores (CACS) (Δ√transformed CACS). Logistic regression models adjusted for interscan periods were used to estimate the odds ratio (OR).

Results: The levels of AIP, TyG index, and HbA1C were significantly higher in diabetics than in non-diabetics. CAC progression was more frequently observed in diabetics (46.9%) than in non-diabetics (28.0%). After adjusting for age, sex, hypertension, hyperlipidemia, obesity, current smoking status, serum creatinine levels, baseline CACS, and interscan period, AIP (per-0.1 unit increase) was associated with CAC progression in only non-diabetics (OR: 1.04, 95% confidence interval [CI]: 1.02 - 1.06; P < 0.001). In contrast, HbA1C level (per-1% increase) was significantly associated with CAC progression in only diabetics (OR: 1.19, 95% CI: 1.08 - 1.32; P = 0.001). The TyG index (per-1 unit increase) was associated with CAC progression in both non-diabetics (OR: 1.32, 95% CI: 1.19 - 1.46; P < 0.001) and diabetics (OR: 1.33, 95% CI: 1.10 - 1.60; P = 0.003).

Conclusions: The associations between AIP, TyG index, and HbA1C levels with CAC progression vary according to established diabetes. Of these biomarkers, TyG index is independently associated with CAC progression irrespective of established diabetes.

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来源期刊
Cardiovascular Diabetology
Cardiovascular Diabetology 医学-内分泌学与代谢
CiteScore
12.30
自引率
15.10%
发文量
240
审稿时长
1 months
期刊介绍: Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.
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