实用老年医学

实用老年医学 ›› 2024, Vol. 38 ›› Issue (5): 491-437.doi: 10.3969/j.issn.1003-9198.2024.05.014

• 临床研究 • 上一篇    下一篇

老年2型糖尿病合并慢性心力衰竭病人HbA1c水平对心脏结构和功能的影响

刘倩慧, 姚子俊, 何玉立, 徐云凡, 吴军   

  1. 210029 江苏省南京市,南京医科大学第一附属医院老年心血管科
  • 收稿日期:2023-10-15 出版日期:2024-05-20 发布日期:2024-05-23
  • 通讯作者: 吴军,Email: wujun9989@njmu.edu.cn
  • 基金资助:
    江苏省高等学校自然科学重大项目(21KJB320003);江苏省卫健委老年健康重点项目(LKZ2023001);江苏省卫健委科研项目(Z2019021, BJ20014);南京医科大学第一附属医院临床能力提升工程面上项目(JSPH-MB-2022-13)

Effects of HbA1c level on cardiac structure and function in elderly patients with type 2 diabetes mellitus and chronic heart failure

LIU Qianhui, YAO Zijun, HE Yuli, XU Yunfan, WU Jun   

  1. Department of Geriatric Cardiology,the First Afliated Hospital of Nanjing Medical University, Nanjing 210029, China
  • Received:2023-10-15 Online:2024-05-20 Published:2024-05-23
  • Contact: WU Jun, Email: wujun9989@njmu.edu.cn

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摘要： 目的 分析老年慢性心力衰竭(心衰)合并T2DM病人HbA1c水平与心脏结构及功能的关系。 方法 210例慢性心衰(NYHA Ⅱ~Ⅳ级)合并T2DM的老年病人以HbA1c平均值≤7%或＞7%分为2组,比较2组血脂水平、心脏结构和功能差异,并分析上述指标与HbA1c的相关性。 结果 HbA1c≤7%组和HbA1c＞7%组室间隔厚度(IVS)、左心室后壁厚度(LVPW)、左心室短轴缩短率(Fs)、LVEF、E/e′以及TC、LDL-C水平差异均具有统计学意义(P＜0.05)。经Spearman相关性分析,HbA1c水平与IVS、LVPW、TC、LDL-C呈正相关(r=0.138、0.152、0.289、0.290,P＜0.05),与LVEF呈负相关(r=-0.196,P＜0.05)。 结论 HbA1c＞7%的T2DM合并慢性心衰的老年病人血TC和LDL-C水平更高。HbA1c水平控制在低于7%范围内可有效延缓心脏结构及功能减退。

关键词: 慢性心力衰竭, 2型糖尿病, 糖化血红蛋白, 心脏结构, 心脏功能

Abstract: Objective To analyze the relationship of glycosylated hemoglobin (HbA1c) level with cardiac structure and function in elderly patients with chronic heart failure and type 2 diabetes (T2DM). Methods A total of 210 elderly patients with chronic heart failure (NYHA gradeⅡ-Ⅳ)combined with T2DM were divided into two groups based on the mean value of HbA1c≤7% or ＞7%.The levels of blood lipid, cardiac structure and function were detected and compared between the two groups.And the correlation of HbA1c with blood lipid, cardiac structure and function were analyzed by Spearman correlation analysis. Results HbA1c ≤ 7% group and HbA1c>7% group showed statistical differences in interventricular septal thickness (IVS), left ventricular posterior wall thickness(LVPW), left ventricular fractional shortening rate (Fs), left ventricular ejection fraction(LVEF), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) (P<0.05). Spearman correlation analysis showed that HbA1c level was positively correlated with the levels of IVS, LVPW, TC and LDL-C(r=0.138, 0.152, 0.289, 0.290, P<0.05), and negatively correlated with the level of LVEF(r=-0.196, P<0.05). Conclusions The elderly patients with T2DM and chronic heart failure whose HbA1c level is higher than 7% have higher levels of TC and LDL-C. Controlling the level of HbA1c below 7% can effectively delay the decline of cardiac structure and function.

Key words: chronic heart failure, type 2 diabetes mellitus, glycosylated hemoglobin, cardiac structure, cardiac function

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