Objective. To investigate the relationship between glycosylated hemoglobin variant index and cardiovascular disease in patients with type 2 diabetes. Methods. A total of 120 patients with type 2 diabetes who were admitted to the Department of Endocrinology in Chun’an Branch of Zhejiang Provincial People’s Hospital from January 2014 to January 2017 were enrolled. The clinical data, fasting blood glucose, and glycosylated hemoglobin levels of the patients were collected, and HGI was obtained by calculating the FPG level into the formula. Follow-up for three years was performed to observe the cardiovascular disease (including coronary heart disease and ischemic stroke) in patients. The occurrence of CVD was analyzed in patients with different levels of HGI. Multivariate logistics regression analysis was used to analyze the risk factors of CVD in patients with T2DM. Results. After three years of follow-up, 8 cases of 120 patients were lost to follow-up. In the end, 24 cases of CVD occurred in 112 patients, with an incidence rate of 21.43%. Comparing the clinical data of CVD patients and non-CVD patients, it was found that the proportion of age, FPG, HbA1c, HGI, and insulin control in the CVD group was higher than that of the non-CVD group, and the difference was statistically significant P < 0.05 . After grouping according to different HGI levels, it was found that with the increase of HGI level, the proportion of HbA1c, FPG, TC, CVD, and insulin use showed an upward trend P < 0.05 . Multivariate logistic regression analysis showed that high HGI level (OR = 4.660), older age (OR = 4.815), and higher FPG level (OR = 1.717) are independent risk factors that affect T2DM patients with cardiovascular disease P < 0.05 . Conclusion. High HGI is independently associated with CVD events in patients with type 2 diabetes. HGI testing is helpful for clinical assessment of personalized assessment and prediction of cardiovascular risk in patients with diabetes.
The aim of this study is to analyze the correlation between the glucose/C-peptide ratio and the risk of disease progression in patients with diabetic nephropathy. Ninety-three patients with diabetic nephropathy, who were treated in the Chun’an Branch of Zhejiang Provincial People’s Hospital, China, from January 2016 to January 2019, were recruited as subjects. In accordance with the disease progression, the patients were divided into a progression group (n = 59) and a nonprogression group (n = 34). Clinical data were compared between the two groups. Pearson’s correlation was applied to analyze the correlation of age, postprandial glucose/C-peptide, glycosylated hemoglobin, insulin resistance index, serum cystatin C, uric acid, 24 h urinary albumin excretion rate (24 hUAER), and estimated glomerular filtration rate (eGFR). Univariate and multivariate logistic regression models were utilized to analyze the influencing factors for the risk of disease progression in patients with diabetic nephropathy. The receiver operating characteristic (ROC) curve was employed to assess the predictive value of postprandial glucose/C-peptide on the risk of disease progression in patients with diabetic nephropathy. Results. The age differences, postprandial glucose/C-peptide, glycosylated hemoglobin, insulin resistance index, serum cystatin C, uric acid, 24 hUAER, and eGFR were significantly different between the two groups P < 0.05 . Pearson’s linear correlation analysis exhibited that postprandial glucose/C-peptide, insulin resistance index, serum cystatin C, and uric acid were positively correlated with 24 hUAER (r = 0.514, 0.345, 0.311, 0.279, P < 0.05 ). Age, postprandial glucose/C-peptide, insulin resistance index, serum cystatin C, and uric acid were negatively correlated with eGFR (r = −0.210, −0.610, −0.351, −0.347, and −0.274, P < 0.05 ). Univariate logistic regression analysis displayed that age (OR = 0.938; P = 0.043 ), postprandial glucose/C-peptide (OR = 0.851; p ≤ 0.001 ), insulin resistance index (OR = 0.219; p ≤ 0.001 ), serum cystatin C (OR = 0.113; p ≤ 0.001 ), and uric acid (OR = 0.989; P = 0.001 ) were risk factors for the risk of disease progression in patients with diabetic nephropathy. Multivariate logistic regression analysis exhibited that postprandial glucose/C-peptide (OR = 0.747; P = 0.004 ), insulin resistance index (OR = 0.072; P = 0.012 ), serum cystatin C (OR = 0.023; P = 0.020 ), and uric acid (OR = 0.967; P = 0.039 ) were independent risk factors for the risk of disease progression in patients with diabetic nephropathy. The ROC curve results demonstrated that the AUC of postprandial glucose/C-peptide predicting the risk of disease progression in patients with diabetic nephropathy was 0.931. Postprandial glucose/C-peptide, insulin resistance index, serum cystatin C, and uric acid are correlated with 24hUAER and eGFR. Postprandial glucose/C-peptide, insulin resistance index, serum cystatin C, and uric acid are independent risk factors for the risk of disease progression in patients with diabetic nephropathy. Among them, postprandial glucose/C-peptide can be employed as a crucial indicator to predict the risk of disease progression in diabetic nephropathy patients.
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