北京部分社区人群血糖与超敏心肌肌钙蛋白T的相关性研究

目的将超敏心肌肌钙蛋白T(hs-cTnT)作为心肌损伤的检测指标,探讨在无冠心病的社区人群中血糖与hs-cTnT的相关性。方法选取1 365例无冠心病的北京部分社区人群作为研究对象,根据血糖水平及既往病史分为糖耐量正常(NGT)组、糖调节异常(IGR)组、糖尿病(DM)组。受试者均进行病史采集,体格检查,化验肝功能、肾功能、空腹血糖(FBG)、餐后2 h血糖(2 hPG)、血脂、超敏C反应蛋白(hs-CRP)、hs-cTnT等指标。结果 DM组hs-cTnT检出率(≥3 ng/L)及升高率(≥13.3 ng/L)均高于NGT组及IGR组,差异有统计学意义(P<0.05)。调整了年龄、性别、吸烟史、高血压史、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、FBG、2 hPG、肾小球滤过率(eGFR)及hs-CRP后,DM组hs-cTnT检出率OR=1.22,95%CI(1.04,1.44),P=0.017]及升高率OR=1.29,95%CI(1.04,1.61),P=0.021]仍高于NGT组。多因素线性逐步回归分析显示:hs-cTnT与多种心血管疾病危险因素相关,其中FBG是hs-cTnT的独立危险因素。结论在无冠心病的社区人群中,随着血糖水平的升高hs-cTnT的分布亦不同,其中hs-cTnT的检出率及升高率在DM人群中均显著升高。hs-cTnT与多项心血管事件危险因素相关,FBG是hs-cTnT的独立危险因素。

Association between Blood Glucose Levels and High-Sensitivity Cardiac Troponins T in Community-Based Population in Beijing Area

Objective To investigate the correlation between blood glucose levels and high-sensitivity cardiac troponins T(hs-cTnT) in community-based population without coronary heart disease(CHD) by using hs-cTnT as measuring indicator for myocardial injury.Methods 1 365 subjects without CHD were recruited and were divided into diabetes mellitus(DM)group,impaired glucose regulation(IGR)group and normal glucose tolerance(NGT)group.The medical history,anthropometry,laboratory measurements including total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),2 hours postprandial blood glucose(2 hPG),estimated glomerular filtration rate(eGFR)high-sensitivity C-reactive protein(hs-CRP),hs-cTnT were detected.Results Compared with NGT group and IGR group,both detectable rate(hs-cTnT≥3 ng/L)and elevated rate(hs-cTnT≥13.3 ng/L)of hs-cTnT were significantly higher in DM group(P<0.05).Even after adjusting age,sex,hypertension,current smoking,BMI,SBP,DBP,eGFR,serum levels of TG,HDL-C,LDL-C,FBG,2 hPG and hs-CRP,the detectable rate of hs-cTnT and elevated rate of hs-cTnT were still higher in DM group compared with NGT group.Multivariable stepwise regression analysis displayed that positive correlations existed between multiple cardiovascular risk factors and hs-cTnT,and FBG was one of the independent risk factors for hs-cTnT.Conclusion hs-cTnT has varied distributions in community-based population with different blood glucose levels.Both detectable rate and elevated rate of hs-cTnT were increased significantly in diabetic population.hs-cTnT was related to multiple risk factors of cardiovascular event.FBG was the independent risk factor for hs-cTnT elevation.