| Objectives:Analyze the clinical characteristics of hemoglobin glycation variation index(HGI)in patients with type 2 diabetes,and explore the correlation between HGI and dyslipidemia and its clinical application.Methods:Six hundred and eighty-five patients with type 2 diabetes mellitus were recruited,who were admitted to the Endocrinology Department of the Second Branch Hospital of Kunming Medical University from July 2019 to January 2021.According to the inclusion and exclusion criteria,Collecting the general clinical data of the patients,including age,gender,height,weight,body mass index(BMI),duration of diabetes,drinking history,smoking history,history of hypertension,and history of hyperlipidemia.At the same time,biochemical tests were performed on venous blood samples from patients,This includes fasting blood glucose(FPG),glycated hemoglobin(HbA1c),triglycerides(TG),total cholesterol(TC),and high-density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),creatinine(Scr).Blood pressure parameters,including diastolic blood pressure and systolic blood pressure,were also collected;the degree of arteriosclerosis was also calculated according to the calculation formula of arteriosclerosis index(AI).After calculating the HGI of 685 enrolled patients with type 2 diabetes,the patients were divided into high HGI group(H-HGI),low HGI group(L-HGI),and medium HGI group(M-HGI)using the tertile method,and the differences in the general clinical data,biochemical parameters,blood pressure,and arteriosclerosis index of the patients in each group were analyzed.Logistic regression was applied to analyze the association of dyslipidemia in patients with type 2 diabetes,while binary logistic regression was applied to analyze the risk of dyslipidemia between HGI and type 2 diabetes.All statistical analyses were calculated using SPSS 25.0 software,and p<0.05 was considered statistically diffierencial.Results:(1)FPG and HbA1c are positively correlated(r=0.489,p<0.01).The linear regression equation of FBG and HbAlc is:predicted HbAlc=0.3×FPG+5.94,and the three-quantile method delineates the HGI interval,which is divided into H-HGI(HGI≥0.368%),L-HGI(HGI<-0.516%),M-HGI(-0.516%<M-HGI<0.368%).(2)There was no significant difference in gender,age,body mass index,drinking history,smoking history,TC,BUN,Scr,ALT,BUN/Scr among the three groups in patients with type 2 diabetes(p>0.05);In H-HGI group,duration of diabetes,FPG,HbA lc,TG,LDL-C,AI,diastolic blood pressure,systolic blood pressure,aspartate aminotransferase(AST),and AST/ALT were significantly higher than those in M-HGI and L-HGI patients;HDL-C were significantly lower in H-HGI group than in M-HGI and L-HGI patients with type 2 diabetes(p<0.05).(3)In the three groups of patients,HGI was positively correlated with TG,LDL-C,and AI,and negatively correlated with HDL-C;the correlation between HGI and blood lipid levels was more significant in patients with H-HGI than in patients with M-HGI and L-HGI.(4)HGI was positively correlated with AST and AST/ALT in the three groups,and the correlation between HGI and liver function was more significant in patients with H-HGI than in patients with M-HGI and L-HGI.(5)Duration of diabetes(OR=1.267,95%CI=1.036～1.652,p<0.05),BMI(OR=1.583,95%CI=1.173～1.986,p<0.05),HbA1C(OR=1.092、95%CI=0.915～1.931、P<0.05)、HGI(OR=1.149、95%CI=1.029～1.328、p<0.001)were risk factors for dyslipidemia in patients with type 2 diabetes.(6)Dyslipidemia occurred 1.629 times more frequently in type 2 diabetic patients in the M-HGI group and 2.931 times more frequently in type 2 diabetic patients in the H-HGI group than in the L-HGI group.(7)Duration of diabetes,BMI,drinking history,hypertension history,FPG,HbAlc,HGI,diastolic blood pressure,systolic blood pressure,AST,AST/ALT were significantly higher in the dyslipidemia group than in the normolipidemia group(p<0.05).Conclusions:1.Type 2 diabetes patients with H-HGI have long course of diabetes,increased risk of dyslipidemia,increased blood glucose and glycosylated hemoglobin levels,increased risk of hypertension,and increased liver damage.2.HGI is one of the possible independent risk factors for dyslipidemia in patients with type 2 diabetes.3.Diabetes patients with high HGI levels usually have increased blood lipid levels,which makes the risk of patients with cardiovascular disease increase rapidly.4.HGI is closely related to chronic liver injury in patients with T2DM.5.HGI has good specificity and sensitivity in predicting dyslipidemia in patients with type 2 diabetes,and can be used as one of the potential indicators for clinical prediction of dyslipidemia and vascular complications in type 2 diabetes. |
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