Association Between HbA1c And NT-ProBNP In Chronic Heart Failure Patients With Type 2 Diabetes

Objective:Research the effect of different glycated hemoglobin Alc(HbAlc) on plasma N-terminal fragment brain natriuretic peptides (NT-proBNP) in chronic heart failure patients with type 2 diabetes.Methods:We enrolled 200 patients which were underwent chronic heart failure with type 2 diabetes in the first hospital of NanPing City from June 2014 to September 2015.Collect the general conditions of gender, age, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), cystatin C (Cys-C), cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), high density lipoprotein (HDL-C), glomerular filtration rate (GFR) and so on in all patients.The glycated hemoglobin Ale (HbAlc) concentration of admission were measured by high performance liquid chromatography (HPLC), and all patients were classified into four groups by tertiles of baseline HbAlc of admission (group A HbAlc≤6.4%, n=48; group B 6.4%<HbA1c≤7.1%,n=62; group C 7.1%<HbA1c≤7.8%, n=44; group D>7.8%, n=46). Plasma NT-proBNP levels of admission and discharge were measured by electrochemical luminescence(ECL), and NT-proBNP levels decrease rate ≥30% as the observation target.Observed NYHA classification of admission and discharge, and NYHA I as the standard of treatment compliance.Results:(1) The level of DBP and TG were on the rise with elevated HbAlc of admission concentration among the four groups. And the comparison of the DBP between each group had a statistical difference (A 66.16±7.72 VS. B 71.08±9.41;A 66.16±7.72 VS. C 76.23±10.41; A 66.16±7.72 VS. D 80.94±12.47; B 71.08±9.41 VS. C 76.23±10.41; B 71.08±9.41 VS. D 80.94±12.47; C 76.23±10.41 VS. D 80.94±12.47, P<0.05), and the comparison of the TG between four groups had a statistical difference(A 1.19±0.24 VS. B 1.31±0.32; A1.19±0.24 VS.C 1.42±0.38; A 1.19±0.24 VS.D 1.52±0.41; B 1.31±0.42 VS. C 1.42±0.38; B 1.31±0.32 VS. D 1.52±0.42; C 1.42±0.38 VS. D 1.52±0.42, P<0.05).But the comparison of the gender, age, HR, SDP, Cys-C, TC, LDL-C, HDL-C, GFR and so on had no statistical difference also (P>0.05).(2) The comparison of the NT-proBNP levels of admission between the four groups had a statistical difference (A 2793.93±548.08 VS. B 3238.19±606.55; A 2793.93 VS. C 3964.09±720.01; A 2793.93 VS. D 4827.28±827.34; B 3238.19±606.55 VS. C 3964.09±720.01; B 3238.19±606.55 VS. D 4827.28±827.34; C 3964.09±720.01 VS. D 4827.28±827.34, P<0.05);and the comparison of the NT-proBNP levels of discharge between groups had a statistical difference also(A 1874.77±532.93 VS. B 2248.16±607.20; A 1874.77±532.93 VS. C 3064.57±714.68; A 1874.77±532.93 VS. D 3968.91±808.17; B 2248.16±607.20 VS. C 3064.57±714.68; B 2248.16±607.20 VS. D 3968.91±808.17; C 3064.57±714.68 VS. D 3968.91±808.17, P<0.05).Positive correlation between HbAlc of admission and Plasma NT-proBNP levels of admission and discharge, and the correlation coefficient between HbAlc of admission and Plasma NT-proBNP levels of admission and discharge approximately equal 0.6. (3) The comparison of Plasma NT-proBNP levels of compliance rate between the two groups(A and B) had no statistical difference (P> 0.05). The comparison of Plasma NT-proBNP levels of compliance rate between the two groups(C and D) had no statistical difference (P> 0.05). But the comparison of the NT-proBNP levels of compliance rate between two groups(A and B; C and D)had a statistical difference (A 68.75% VS. C 38.64%; A 68.75% VS. D 34.78%; B 64.52% VS. C 38.64%; B 64.52% VS. D 34.78%, P<0.05). (4) The comparison of the NYHA classification of admission between groups had a statistical difference in each group(P<0.05). And the comparison of the NYHA classification of compliance rate between the two groups(A and B) had no statistical difference (P>0.05); the comparison of the NYHA classification of compliance rate between the two groups(C and D) had no statistical difference (P>0.05); but the comparison of the NYHA classification of compliance rate between two groups(A and B; C and D)had a statistical difference (A 70.83% VS. C 45.45%; A 70.83% VS. D 43.48%; B 72.58% VS. C 45.45%; B 72.58% VS. D 43.48%, P<0.05).ConclusionsPositive correlation between HbAlc of admission and plasma NT-proBNP levels of admission and discharge, and the HbAlc concentration of admission has an effect on the dynamic changes of plasma NT-proBNP levels of admission and discharge, when HbAlc or less 7.1%, compliance rate of plasma NT-proBNP levels increased significantly, and NYHA functional improved significantly, namely that the treatment significantly improved in chronic heart failure patients with type 2 diabetes.