Study On Correlation Between Glycated Hemoglobin And Homocysteine With Cardiac Function Of Aged Diabetic Patients

Objective:To investigate the relationship between glycosylated hemoglobin(HbAlc)and homocysteine(Hcy)levels in elderly patients with clinical diabetes mellitus(DM),to evaluate the significance of prevention and monitoring of HbAlc combined with Hcy detection in patients with clinical diabetes mellitus with heart failure or cardiovascular disease.Methods:Selected in November 2015-November 2016,Qinghai University Hospital,affiliated Hospital of elderly patients with 168 cases,at the same time in the Qinghai University Hospital aged 60 cases of health care for the control group,are Han,older than or equal to 60 years old.Including 120 males(53%)and 108 females(47%).All patients were recorded with age,sex,DM duration,Calculate body mass index(BMI),Draw venous blood fasting plasma glucose(FPG),glycosylated hemoglobin(HbAlc),homocysteine(Hcy),amino terminal B type natriuretic peptide(BNP),24 h blood pressure monitoring 24 h pulse pressure(24h PP),night systolic blood pressure reduction rate(SBPF),Echocardiography was used to measure left ventricular ejection fraction(LVEF),left ventricular diastolic and late mitral valve maximum blood flow ratio(E/A),DM patients with cardiac dysfunction were graded according to the NYHA scale.(1)The differences of HbA1 c and Hcy between the control group and DM group.The differences of HbA1 c and Hcy between different levels of DM with cardiac dysfunction(grade ?,grade ?,grade grade? ?);(2)DM group and DM with cardiac dysfunction(grade ?,grade?,grade ?grade ?)were the above indicators of comparative analysis.Results:1.Compared with the control group,the levels of HbA1 c and Hcy in DM group were significantly higher than those in control group(P<0.05);The levels of HbA1 c and Hcy were also increased with the increase of heart function level,and there was significant difference between the two groups(P<0.05).The correlation between HbA1 c and Hcy was positively correlated(r=0.780),and the results were statistically significant(P<0.05).2.Statistical analysis was performed on the DM group with cardiac dysfunction,and the age,gender,FPG,BMI,E/A,and DM were not significantly different between the four groups(P>0.05),Hcy,HbA1 c,BNP,24 hPP,SBPF and LVEF were statistically different between the four grades(P<0.05).(1)There was a positive correlation between HbA1 c and BNP and 24hPP(r=0.742?r=0.534),there was a negative correlation between HbA1 c and SBPF and LVEF(r=-0.401?r=-0.740),there was a positive correlation between Hcy and BNP and 24hPP(r=0.611?r=0.488),there was a negative correlation between Hcy and SBPF and LVEF(r=-0.295 ?r=-0.670.(2)Multivariate regression analysis was performed on the six indicators with statistical difference,the results showed that the OR values of HbA1 c,Hcy and BNP were 1.853(1.205~2.850),2.262(1.174~1.357)and 1.016(1.005~1.026),respectively.HbA1 c,Hcy,BNP increased by 1.853,1.144 and 1.016 times for each additional unit,DM with cardiac insufficiency.Conclusion:1.With the increase of HbA1 c and Hcy levels,the degree of heart function in elderly patients with diabetes mellitus gradually increased.Besides,Hcy and HbA1 c were positively correlated.2.Hcy and HbA1 c can be used as an independent risk factor for cardiac dysfunction in elderly patients with diabetes mellitus.3.Monitoring of HbAlc and Hcy in elderly patients with diabetes,can conjecture The development trend that the cardiac function in some extent.