| Objective: To explore the relationship between Hemoglobin Glycation Index(HGI)and macrovascular disease in patients with Type 2 Diabetes Mellitus(T2DM).Methods: Collect T2 DM cases hospitalized in the Endocrinology Department of Hefei First People’s Hospital and Hefei Binhu Hospital from 2010 to 2017,collect gender,age,diabetes course,smoking history,drinking history,family history of diabetes,history of hypertension,History of fatty liver,coronary heart disease,history of cerebrovascular disease,history of foot ulcer,systolic blood pressure(SBP),diastolic blood pressure(DBP),height,weight,body mass index(BMI),Fasting plasma glucose(FPG),glycosylated hemoglobin Alc(Hb A1c),fasting C peptide(FCP),total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),serum creatmne(SCr),uric acid(UA),hemoglobin(Hb),carotid artery and lower extremity vascular color Doppler ultrasound,head CT/MRI,coronary artery CTA,coronary angiography,etc.And enter the above information through Epidata software and export it to an excel table to eliminate cases with incomplete information.In strict accordance with the inclusion and exclusion criteria,1747 cases were finally screened out,the HGI value was calculated,and divided into three groups of low HGI,medium HGI,and high HGI according to the tertile method,and SPSS 26.0 software was used to analyze the arteries between the three groups Differences in the incidence of vascular disease,and to evaluate the relationship between HGI levels and the occurrence of diabetic macrovascular disease.Results: 1.Comparison of the clinical characteristics of the study subjects among the three groups:(1)The age,course of disease,BMI,SBP,DBP,FPG,Hb A1 c,UA,TG and LDL-C of the three groups were significantly different(P <0.05);(2)Compared with the low HGI group Compared with the middle HGI group,the disease course,SBP,FPG,Hb A1 c and LDL-C were higher than the middle HGI group,while TG and UA were lower than the low HGI group;the age of the high HGI group,FPG,Hb A1 c and LDL-C were higher than low HGI group,and BMI is lower than low HGI group.The above differences are statistically significant(P﹤0.05);(3)Compared with the middle HGI group,the age and Hb A1 c of the high HGI group are higher than those of the middle HGI group,while the disease course,BMI,TG,UA,SBP,and DBP are lower For the former,the difference was statistically significant(P<0.05).2.Detection of vascular disease in each group:(1)With the increase of HGI group,the detection rate of carotid artery disease,lower extremity vascular disease and total macrovascular disease also increased significantly,and this difference was statistically significant(P ﹤0.05);(2)The detection rates of carotid artery disease,lower extremity vascular disease and total macrovascular disease in the medium and high HGI group were higher than those in the low HGI group;the detection rate of carotid artery disease and total macrovascular disease was higher in the high HGI group In the HGI group,this difference was statistically significant(P﹤0.05);(3)There was no significant difference in the detection rates of coronary heart disease and cerebrovascular disease among the three groups(P>0.05).3.Taking the occurrence of T2 DM macrovascular disease as the dependent variable,taking HGI,gender(1 for males,0 for females),age,course of disease,BMI,SBP,DBP,Hb A1 c,UA,TG,TC,LDL-C,HDL-C and fatty liver are independent variables,and two-class logistic regression analysis is performed:(1)Age(OR = 1.047,P = 0.002),BMI(OR = 1.109,P = 0.036),and disease course(OR= 1.006,P = 0.001)are risk factors for coronary heart disease in patients with T2 DM.(2)Age(OR = 1.072,P <0.001),uric acid(OR = 1.003,P = 0.045),are risk factors for cerebrovascular disease in patients with T2 DM,HDL-C(OR = 0.400,P= 0.022)is a protective factor.(3)HGI(OR=1.130,P=0.035),female(OR=0.546,P<0.001),age(OR=1.089,P<0.001),course of disease(OR=1.003,P=0.001)are risk factors for carotid arterial disease.(4)HGI(OR=1.133,P=0.039),female(OR=0.352,P ﹤ 0.001),age(OR=1.091,P ﹤0.001),course of disease(OR=1.002,P=0.015),DBP(OR =1.014,P=0.017),TG(OR=1.206,P=0.037)are risk factors for LEAD in patients with T2 DM,while BMI(OR=0.950,P=0.008)is a protective factor.(5)HGI(OR=1.339,P﹤0.001),female(OR=0.326,P﹤0.001),age(OR=1.107,P﹤0.001),course of disease(OR=1.004,P=0.002)is the size of T2 DM patients risk factors for macrovascular disease,and BMI(OR=0.953,P=0.026 is a protective factor.4.Logistic regression analysis was performed in the form of HGI tertile group and the condition of macrovascular disease.With the low HGI group as the reference group,after adjusting for the effects of gender,age,disease course,and BMI,the results showed that the middle HGI group and the high HGI group the risk of macrovascular disease was 1.54 times(OR=1.540,P=0.004)and 2.036 times(OR=2.036,P﹤0.001)of the low HGI group.Conclusion: HGI is a risk factor for carotid artery disease,lower limb artery disease and macrovascular disease in patients with type 2 diabetes mellitus.And HGI may have important predictive value for macrovascular disease. |
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