糖化血红蛋白变异指数与2型糖尿病患者糖尿病慢性并发症的相关性研究

目的 探讨2型糖尿病（T2DM）患者糖化血红蛋白变异指数（HGI）与糖尿病慢性并发症发病的关系。方法 采用整群随机抽样的方法,从常熟市34个乡镇中随机抽出12个乡镇,选取在抽中乡镇登记并纳入国家基本公共卫生服务管理的T2DM患者为研究对象。根据HGI数值,采用三分位数法将患者分为低HGI组、中HGI组和高HGI组,探索HGI水平与T2DM患者糖尿病慢性并发症之间的关联。单因素分析采用χ²检验,多因素分析采用多因素Logistic回归模型。结果 共10 246例T2DM患者纳入分析,其中年龄≥60岁者占66.41%,男性4 157例,女性6 089例。单因素分析显示,HGI与T2DM患者糖尿病慢性并发症、糖尿病视网膜病变有显著关联性（均P<0.01）,而未发现HGI与糖尿病肾病、糖尿病神经病变及糖尿病足之间存在关联性（均P>0.05）。调整年龄、性别、文化程度、吸烟史、肥胖、血脂异常、糖尿病病程、糖尿病家族史等因素后,多因素Logistic回归分析显示,与低HGI组相比,高HGI组更容易发生糖尿病慢性并发症（OR=1.240,95% CI：1.091~1.409）和糖尿病视网膜病变（OR=1.240,95% CI：1.070~1.437）。结论 高HGI水平的T2DM患者可能更易发生糖尿病慢性并发症,尤其是糖尿病视网膜病变。

Correlation between hemoglobin glycation index and chronic complications of diabetes mellitus in patients with type 2 diabetes

Objective To explore the correlation between hemoglobin glycation index （HGI） and chronic complications of diabetes mellitus in patients with type 2 diabetes （T2DM）. Methods Cluster random sampling method was used to select 12 from 34 villages and towns in Changshu City, and T2DM patients registered in the selected villages and towns and included in the management of National Basic Public Health Services were selected as the research objects. The participants were divided into low HGI group, middle HGI group and high HGI group according to the HGI value. The correlation of HGI and the risk of chronic complications of diabetes mellitus was estimated. Univariate analysis was performed by Chi-square test and multivariate analysis by multivariate Logistic regression model. Results A total of 10 246 T2DM patients （4 157 males and 6 089 females） were included in the survey, with 66.41% aged over 60 years old. Univariate analysis showed that HGI was significantly associated with chronic complications of diabetes mellitus and diabetic retinopathy （both P<0.01）. But no significant associations of HGI with diabetic nephropathy, diabetic neuropathy and diabetic foot were found （all P>0.05）. After adjusting for age, sex, education, smoking history, obesity, dyslipidemia, diabetes duration and family history of diabetes, Logistic regression analysis showed that high HGI group had a significantly increased risk of chronic complications of diabetes mellitus （ OR=1.240, 95% CI： 1.091-1.409） and diabetic retinopathy （OR=1.240, 95% CI： 1.070-1.437） compared with low HGI group. Conclusion The patients with high HGI may be more likely to develop chronic complications of diabetes mellitus, especially diabetic retinopathy.