中国全科医学2017，Vol.20Issue(36)：4480-4483,4488,5.DOI:10.3969/j.issn.1007-9572.2017.00.153
非酮症糖尿病患者糖化血红蛋白与红细胞分布宽度变异系数和甲状腺过氧化物酶抗体阳性率的相关性及其变化的影响因素研究
Relationship of HbA1c with RDW-CV and TPOAb and Associated Factors for HbA1c Changes in Nonketotic Diabetic Patients
摘要
Abstract
Objective To investigate the relationship of glycated hemoglobin (HbA 1c )with red blood cell distribution width (RDW-CV)and thyroid peroxidase antibody (TPOAb),and the associated factors for HbA 1c changes in nonketotic diabetic patients. Methods According to the inclusion criteria,we selected 413 nonketotic diabetic patients who received inpatient treatment in Department of Endocrinology of Yiyang Central Hospital from March 2014 to April 2016. The patients were grouped according to HbA1c level:HbA 1c ≤7. 5％ (group A,n = 128),7. 5％ < HbA 1c < 10. 0％ (group B,n = 190), HbA1c≥10. 0％ (group C,n = 95). The distribution of sex and age,course of nonketotic diabetes,body mass index (BMI),RDW-CV,low density lipoprotein (LDL),total cholesterol (TC),24-hour urine trace albumin (24 h UAE),C -reactive protein (CRP),fasting C peptide (FCP),postprandial 2 h C-peptide (PCP),free triiodothyronine (FT 3 )and free thyroxine (FT 4 ),thyroid stimulating hormone (TSH),glutamic acid decarboxylase antibody (GADA)positive rate,rate of abnormal TPOAb were compared among the 3 groups. The correlation between HbA1c and the above indicators,and independent risk factors for HbA1c changes in these patients were analyzed. Results Group A had shorter course of nonketotic diabetes,lower RDW-CV and lower TSH and rate of abnormal TPOAb than the other two groups (P < 0. 05);group C had longer course of nonketotic diabetes,higher RDW-CV and higher TSH and rate of abnormal TPOAb compared with group B (P < 0. 05) . Spearman rank correlation analysis showed that HbA1c was positively correlated with course of nonketotic diabetes,RDW-CV, rates of abnormal TPOAb and TSH (r s = 0. 681,0. 630,0. 432 and 0. 438,respectively;P < 0. 001,P < 0. 001,P = 0. 001, P = 0. 001,respectively). RDW-CV 〔OR = 2. 024,95％ CI (1. 237,4. 103)〕,rate of abnormal TPOAb level 〔OR =1. 243,95％ CI (1. 134,1. 548)〕,and TSH 〔OR = 1. 814,95％ CI (1. 567,3. 234)〕were independent risk factors for changes in HbA1c level (P < 0. 05). Conclusion In nonketotic diabetes,RDW-CV and the rate of abnormal TPOAb were positively correlated with HbA1c ,and they were independent risk factors for changes in HbA 1c . Therefore,poor control of fasting blood glucose and the change of red blood cell morphology could increase the risk of immune thyroid diseases.关键词
糖尿病,非酮症性/血红蛋白A,糖基化/红细胞分布宽度/甲状腺过氧化酶/影响因素分析Key words
Diabetes mellitus,ketosis-resistan/Hemoglobin A,glycosylated/Red cell distribution width/Thyroid peroxidase/Root cause analysis分类
医药卫生引用本文复制引用
彭韦霞,贺佩祥,刘丽君,钟雅琴,彭可,李菊香,徐雪辉,丁婷,陈锋..非酮症糖尿病患者糖化血红蛋白与红细胞分布宽度变异系数和甲状腺过氧化物酶抗体阳性率的相关性及其变化的影响因素研究[J].中国全科医学,2017,20(36):4480-4483,4488,5.基金项目
湖南省医药卫生科研计划项目(B2014-174) （B2014-174）
