Predictive value of hemoglobin glycation index and monocyte to high-density lipoprotein-cholesterol ratio in type 2 diabetes mellitus with cerebral small vessel disease
Predictive value of hemoglobin glycation index and monocyte to high-density lipoprotein-cholesterol ratio in type 2 diabetes mellitus with cerebral small vessel disease
薛慧 1邓旭 1李颖 1刘婷婷 2葛坚 2韩远远 2费秀云
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作者信息
1. 宿迁市第一人民医院内分泌科，宿迁 223800
2. 宿迁市第一人民医院神经内科，宿迁 223800
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摘要
目的 探讨糖化血红蛋白变异指数（HGI）和单核细胞/高密度脂蛋白胆固醇比值（MHR）对2型糖尿病（T2DM）伴脑小血管病（CSVD）的预测价值。 方法 为横断面研究。选取2020年1月至2022年12月在宿迁市第一人民医院内分泌科和神经内科住院的T2DM患者为研究对象。根据是否伴有CSVD将患者分为单纯T2DM和T2DM伴CSVD组。收集两组患者的单核细胞计数、高密度脂蛋白胆固醇（HDL-C）、糖化血红蛋白（HbA1c）、空腹血糖（FPG），并计算MHR和HGI。两组间比较采用两独立样本t检验、Mann‐Whitney U检验或χ2检验，采用Spearman相关性分析法分析HGI和MHR与T2DM伴CSVD的相关性，采用多因素logistic回归分析法分析T2DM伴CSVD的影响因素，采用受试者工作特征（ROC）曲线评估HGI和MHR对T2DM伴CSVD的诊断价值。 结果 共纳入361例T2DM患者。其中，单纯T2DM组170例，T2DM伴CSVD组191例。与单纯T2DM组相比，T2DM伴CSVD组患者MHR和HGI均更高（P<0.001）。Spearman相关性分析结果显示，HGI（r=0.196，P<0.001）、MHR（r=0.349，P<0.001）与T2DM伴CSVD均呈正相关。多因素logistic回归分析结果显示，HGI（OR=1.314，95%CI 1.052~1.642，P=0.016）和MHR（OR=1.056，95%CI 1.039~1.073，P<0.001）均为T2DM伴CVSD的影响因素。ROC曲线分析结果显示，HGI、MHR预测T2DM伴CSVD的曲线下面积分别为0.613（95%CI 0.555~0.671，P<0.001）和0.702（95%CI 0.649~0.755，P<0.001），HGI和MHR联合预测T2DM伴CSVD的曲线下面积为0.729（95%CI 0.678~0.780，P<0.001）。 结论 HGI和MHR与T2DM患者的CSVD发病密切相关，对T2DM伴CSVD的预测均有一定的价值，两者联合预测价值更高。 Objective To explore the predictive value of hemoglobin glycation index (HGI) and monocyte to high-density lipoprotein-cholesterol ratio (MHR) in type 2 diabetes mellitus (T2DM) with cerebral small vessel disease (CSVD). Methods This was a cross-sectional study. Patients with T2DM who were hospitalized in the Department of Endocrinology and Department of Neurology of Suqian First Hospital from January 2020 to December 2022 were enrolled as the subjects. Patients were divided into T2DM alone group and T2DM with CSVD group according to whether they were combined with CSVD. Monocyte counts, high-density lipoprotein-cholesterol (HDL-C), glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG) were collected, and MHR and HGI were calculated. Two independent sample t test, the Mann-Whitney U test, or the χ2 test were used for the comparisons between the two groups. Spearman correlation was used to analyze the correlation between HGI and MHR and T2DM with CSVD. Multivariate logistic regression analysis was used to determine the influencing factors of T2DM with CSVD. Receiver operating characteristic (ROC) curve was used to assess the diagnostic value of HGI and MHR for T2DM with CSVD. Results A total of 361 patients with T2DM were included. There were 170 patients in the T2DM alone group and 191 patients in the T2DM with CSVD group. Compared with T2DM alone, patients in T2DM with CSVD group had higher MHR and HGI (P<0.001). Spearman correlation analysis showed that both HGI (r=0.196, P<0.001) and MHR (r=0.349, P<0.001) were positively correlated with T2DM and CSVD. Multivariate logistic regression analysis showed that both HGI (OR=1.314, 95%CI 1.052-1.642,P=0.016) and MHR (OR=1.056, 95%CI 1.039-1.073, P<0.001) were the influencing factors of T2DM with CVSD. The results of ROC curve analysis showed that the areas under the HGI and MHR were 0.613 (95%CI 0.555-0.671,P<0.001) and 0.702 (95%CI 0.649-0.755,P<0.001), respectively. The area under the curve predicted by HGI and MHR was 0.729 (95%CI 0.678-0.780,P<0.001). Conclusion HGI and MHR are closely related to the onset of CSVD in T2DM patients, and have certain value in predicting T2DM with CSVD, their combined diagnostic value is higher.
Abstract
Objective To explore the predictive value of hemoglobin glycation index (HGI) and monocyte to high-density lipoprotein-cholesterol ratio (MHR) in type 2 diabetes mellitus (T2DM) with cerebral small vessel disease (CSVD). Methods This was a cross-sectional study. Patients with T2DM who were hospitalized in the Department of Endocrinology and Department of Neurology of Suqian First Hospital from January 2020 to December 2022 were enrolled as the subjects. Patients were divided into T2DM alone group and T2DM with CSVD group according to whether they were combined with CSVD. Monocyte counts, high-density lipoprotein-cholesterol (HDL-C), glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG) were collected, and MHR and HGI were calculated. Two independent sample t test, the Mann-Whitney U test, or the χ2 test were used for the comparisons between the two groups. Spearman correlation was used to analyze the correlation between HGI and MHR and T2DM with CSVD. Multivariate logistic regression analysis was used to determine the influencing factors of T2DM with CSVD. Receiver operating characteristic (ROC) curve was used to assess the diagnostic value of HGI and MHR for T2DM with CSVD. Results A total of 361 patients with T2DM were included. There were 170 patients in the T2DM alone group and 191 patients in the T2DM with CSVD group. Compared with T2DM alone, patients in T2DM with CSVD group had higher MHR and HGI (P<0.001). Spearman correlation analysis showed that both HGI (r=0.196, P<0.001) and MHR (r=0.349, P<0.001) were positively correlated with T2DM and CSVD. Multivariate logistic regression analysis showed that both HGI (OR=1.314, 95%CI 1.052-1.642,P=0.016) and MHR (OR=1.056, 95%CI 1.039-1.073, P<0.001) were the influencing factors of T2DM with CVSD. The results of ROC curve analysis showed that the areas under the HGI and MHR were 0.613 (95%CI 0.555-0.671,P<0.001) and 0.702 (95%CI 0.649-0.755,P<0.001), respectively. The area under the curve predicted by HGI and MHR was 0.729 (95%CI 0.678-0.780,P<0.001). Conclusion HGI and MHR are closely related to the onset of CSVD in T2DM patients, and have certain value in predicting T2DM with CSVD, their combined diagnostic value is higher.
关键词
糖尿病,2型/脑小血管病/糖化血红蛋白变异指数/单核细胞/高密度脂蛋白胆固醇比值
Key words
Diabetes mellitus, type 2/Cerebral small vessel disease/Hemoglobin glycation index/Monocyte to high-density lipoprotein-cholesterol ratio
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