中国脑血管病杂志2025，Vol.22Issue(5)：310-316,348,8.DOI:10.3969/j.issn.1672-5921.2025.05.003
糖化血红蛋白变异指数与颈动脉斑块内新生血管的相关性研究
Correlation between the hemoglobin glycation index and carotid intraplaque neovascularization
摘要
Abstract
Objective To investigate the correlation between the hemoglobin glycation index(HGI)and the severity of intraplaque neovascularization(IPN)in patients with mild-to-moderate carotid artery stenosis.Methods This study retrospectively and consecutively enrolled patients with mild-to-moderate carotid artery stenosis(＜70%narrowing)hospitalized in the Department of Neurology at the Hefei Second People's Hospital between June,2020 and June,2024.Demographic data(age,gender),personal history(smoking,drinking),cerebrovascular risk factors(hypertension,diabetes,hyperlipidemia),body mass index,and laboratory indicators from fasting venous blood collected on the second morning of hospital admission(neutrophils,lymphocytes,neutrophil-to-lymphocyte ratio,platelet count,total cholesterol,triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol(LDL-C),homocysteine,blood glucose,and glycated hemoglobin[HbA1c])were collected and compared.A univariate linear regression analysis was performed to assess the relationship between fasting blood glucose and HbA1c levels measured on the second day after admission,yielding the prediction formula:predicted HbA1c(%)=0.571×fasting blood glucose(mmol/L)+3.125.Subsequently,HGI was calculated through:HGI=actual HbA1c-predicted HbA1c.Carotid ultrasound was used to measure patients'carotid intima-media thickness,and,plaque location,thickness(maximum plaque diameter),length,echogenicity,and resistance index.For patients with multiple plaques,the thickest plaque was selected as the target plaque.Using the AngioPLUS mode of carotid ultrasound,dynamically observe for presence of IPN at the filling defect of the carotid artery plaque.The IPN condition of the target plaque was then assessed,including the number,location,morphology(e.g.,punctate,short linear,etc.),and spectral Doppler characteristics of the new blood vessels.The IPN signals were counted and scored according to the following criteria:absence of high-echogenicity blood flow signals in the target carotid artery plaque indicating no neovascularization,was scored as 0 point;the presence of fewer than 4 punctate or short linear hyperechoic blood flow signals within the target plaque was scored as 1 point;the presence of diffusely distributed(≥4)short linear or strip-like hyperechoic blood flow signals within the plaque was scored as 2 points.A higher IPN score indicates a more severe degree of IPN.Patients with an IPN score of 0-1 were categorized as the low IPN score group,while those with an IPN score of 2 were classified as the high IPN score group.Indicators with statistically significant differences between the two groups in the univariate analysis and exhibited no multicollinearity were included in the multivariate binary Logistic regression model to analyze the relationship between HGI and the severity of carotid IPN.Results A total of 387 patients(222 males and 165 females,with a mean age of[70±10]years)with mild-to-moderate carotid artery stenosis were included in this study.Among the 387 patients enrolled,97 were in the low IPN score group,while 290 were in the high IPN score group.(1)The high IPN score group exhibited significantly higher average age([71±10]years vs.[67±10]years),higher prevalence of hypertension(79.7%[231/290]vs.67.0%[65/97]),higher prevalence of diabetes(37.6%[109/290]vs.14.4%[14/97]),greater plaque thickness(2.40[2.00,3.10]mm vs.2.30[1.80,2.70]mm),higher HbA1c levels(6.25%[5.70%,7.20%]vs.5.80%[5.50%,6.40%]),and higher HGI values(-0.05%[-0.39%,0.46%]vs.-0.29%[-0.56%,-0.10%])in comparison to the low IPN score group(all P＜0.05).Additionally,the high IPN score group had significantly lower lymphocyte ratios([27.75±9.19]%vs.[30.17±9.04]%)and lower LDL-C levels([2.19±0.81]mmol/L vs.[2.43±0.91]mmol/L;both P＜0.05).(2)The results of multivariate Logistic regression analysis indicated that age(OR,1.031,95%CI 1.004-1.060,P=0.027),HGI(OR,1.782,95%CI 1.066-2.979,P=0.028),and plaque thickness(OR,1.750,95%CI 1.229-2.490,P=0.002)were independent influencing factors associated with the severity of IPN in the mild-to-moderate carotid artery stenosis.Conclusions High HGI may serve as an independent risk factor for the severe IPN in patients with mild-to-moderate carotid artery stenosis.However,the findings of this study require further validation through multi-center,large-scale,prospective clinical trials.关键词
颈动脉/血糖/数据相关性/糖化血红蛋白变异指数/斑块内新生血管Key words
Carotid artery/Blood glucose/Correlation of data/Hemoglobin glycation index/Intraplaque neovascularization引用本文复制引用
张皓,曹树刚,贺军,夏明武..糖化血红蛋白变异指数与颈动脉斑块内新生血管的相关性研究[J].中国脑血管病杂志,2025,22(5):310-316,348,8.基金项目
合肥市卫生健康委员会应用医学研究项目(Hwk2022zd004) （Hwk2022zd004）
安徽医科大学校科研基金项目(2023xkj231) （2023xkj231）
