6.5% 미만의 당화혈색소와 경동맥 내막중격 두께의 관계
The Correlation between Hemoglobin A1c and Common Carotid Artery Intima Medial Thickness of Both Genders with Less Than 6.5% HbA1c Based on Ultrasound Measurement
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초록
연구배경: 본 연구에서는 당화헤모글로빈 6.5% 미만인당뇨병 이전 단계에서 혈관질환의 위험성을 알아보기 위해 당화헤모글로빈과 경동맥 내막중격 두께의 관계를 알아보고자 하였다. 방법: 당화헤모글로빈 검사와 경동맥초음파 검사를 시행한 336명을 대상으로 당화헤모글로빈을 기준으로 정상과고위험군으로 나누어 남녀에 따른 당화헤모글로빈과 경동맥 내막중격 두께의 상관관계를 Pearson's correlation으로, 경동맥 내막중격 두께에 더 큰 영향을 주는 요소를 알아보기 위해서 multiple linear regression model로 분석하였다. 결과: 나이와 공복 시 혈당은 남녀 모두에서 경동맥 내막중격 두께와 상관관계가 있었고, 남자에서는 당화헤모글로빈과 CRP, 여자에서는 고밀도지단백(HDL)과 허리엉덩이 둘레비가 경동맥 내막중격 두께와 의미 있는 상관관계를 보였다. 그중 남자에서는 나이와 당화헤모글로빈이, 여자에서는 나이만이 경동맥 내막중격 두께에 큰 영향을 주었다. 결론: 당뇨병으로 진단되지 않은 사람이라도 당화헤모글로빈과 경동맥 내막중격 두께가 상관관계가 있었고 이러한 결과는 당뇨병 환자뿐만 아니라 당뇨병 이전 상태에서도 혈당 상태를 확인하여 혈관 질환의 위험성을 예측할수 있다.
Abstract
Background: The glycemic control in diabetes is well known to arouse a medical risk of macrovascular regions. This study aimed for exploring the relationship between carotid artery intima media thickness (IMT) and the risk triggers of macrovascular diseases in the group of glycated hemoglobin value less than 6.5%. Methods: The subjects were made of 336 health-check examinees in a university hospital and tested by glycated hemoglobin (HbA1c) including ultrasound application on carotid artery IMT to be measured. The relationship between values of HbA1c and carotid artery IMT was reviewed by use of Pearson's correlation, and then influential causes on the carotid artery IMT were analyzed with multiple linear regression models. Results: Elements like age and fasting plasma glucose were associated with the carotid artery IMT in both men and women. HbA1c, C-reactive protein (CRP) in men and waist to hip ratio (WHR), high-density lipoprotein (HDL)-cholesterol in women showed statistically significant association with the carotid artery IMT. Age and HbA1c were recognized as variables affecting on the carotid artery IMT in men, in contrast, age was only a significant affecting factor in women with regarding various considerations such as fasting plasma glucose, CRP, HDL, WHR and smoking. Conclusions: Our clinical investigation revealed that HbA1c was associated with the carotid artery IMT in normal and pre-diabetes with HbA1c less than 6.5%. The outcome might suggest preliminary glucose control be monitored and managed in order to detect and regulate the impairment of macrovascular diseases prior to the occurrence of diabetes.
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