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Objective:To explore the correlation between glycated hemoglobin variability index (HGI) and carotid artery plaque in patients with type 2 diabetic kidney disease (DKD).Methods:This cross-sectional study included 620 DKD patients admitted to the Department of Endocrinology in the First Affiliated Hospital of Nanjing Medical University from June 2019 to June 2022. Basic demographic and laboratory data, including age, disease duration, body mass index (BMI), blood pressure, fasting blood glucose (FBG), glycated hemoglobin (HbA 1c), lipid profile, and urinary albumin excretion rate (UAER), were collected for all participants. A linear regression equation was developed based on FPG and HbA 1c to calculate the HGI level of each patient. The patients were divided into low HGI group, medium HGI group, and high HGI group based on the tertiles of HGI. The detection rate of carotid artery plaque in the three HGI groups was analyzed. The patients were further divided into the non-plaque group (254 cases) and plaque group (366 cases) based on the presence or absence of carotid artery plaque. Binary logistic regression analysis was used to identify the risk factors for carotid artery plaque in DKD patients. Results:Among the DKD patients, the detection rate of carotid artery plaque was 59%. Compared with the non-plaque group, the patients in the plaque group had older age (60.52 years, t=-7.71), longer disease duration (10 years, Z=-4.17), higher systolic blood pressure (141.9 mmHg, t=-3.29), higher HbA 1c (9.2%, Z=-2.17), higher HGI (-0.20%, Z=-3.43), higher urea nitrogen (6.87 μmol/L, Z=-3.96), higher creatinine (77 mmol/L, Z=-4.05), and higher UAER (234.25 mg/24 h, Z=-5.59) (all P<0.05). The detection rate of carotid artery plaque in the low HGI group, medium HGI group and high HGI group was 50.5%, 57.9% and 68.5%, respectively, with a statistically significant difference among the three groups (χ 2=14.15, P=0.001). Age, UAER, and HGI were identified as risk factors for carotid artery plaque ( OR=1.051, 2.775 and 1.474, all P<0.05). The risk of carotid artery plaque in the high HGI group was 2.142 times of that in the low HGI group. After adjusting for confounding factors such as age, gender, disease duration, BMI, blood pressure, lipid profile and UAER, the risk of carotid artery plaque in the high HGI group was 2.558 times of that in the low HGI group. Conclusion:HGI is significantly elevated in DKD patients with carotid artery plaque, and the detection rate of carotid artery plaque increases with HGI level. Elevated HGI is an independent risk factor for carotid artery plaque in DKD patients.
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Objective To detect serum Vaspin level in subjects with normal glucose regulation(NGR)and newly-diagnosed type 2 diabetes mellitus (T2DM) ,and to investigate the association between serum Vaspin and body mass index (BMI), age, gender, glycometabolism and lipemetabolism and insulin sensitivity index. Methods The fasting serum levels of Vaspin were measured in 48 normal controls and 66 T2DM patients using enzyme linked immunosorbent assay ( ELISA ). BMI, waist-hip ratio (WHR) and % body fat were measured,as well as fasting blood glucose (FBG), HBA1C, lipids and insulin levels. Results The fast serum Vaspin concentrations in the obese T2DM patients was ( 1.13 ±0. 25 ) μg/L,which were significantly higher than that in the non-obese T2DM patients (0. 65 ± 0. 13 ) μg/L (P ＜ 0. 01 ). In the NGR group, the fast serum Vaspin concentrations in the obese was (0. 95 ± 0. 11 ) μg/L, which were significantly higher than that in the non-obese (0. 38 ± 0. 18) μg/L( P ＜ 0. 01 ). In the T2DM group, serum Vaspin concentration in females ( [0. 92 ± 0. 35]μg/L) was higher than in males ([0.76 ± 0. 22] μg/L) (P ＜ 0.01 ). In the NGR group, serum Vaspin concentration in females was also higher than that in males ( [1.05 ± 0. 21] μg/L vs [0. 48 ± 0. 14] μg/L) )(P＜0. 01 ). Serum Vaspin level was positively correlated with BMI,WHR,% Body Fat,fasting insulin(FINS)and insulin sensitivity index (ISI) (r = 0. 365,0. 214,0. 238,0. 183 and 0. 147, respectively, Ps ＜ 0. 05 ). The multiple stepwise regression analysis showed that gender( R2 = 0. 161, P ＜ 0. 01 ), ISI ( R2 = 0. 183, P ＜ 0. 01 )and WHR( R2 = 0. 216, P ＜ 0. 01 ) were independent variables associated with Vaspin. Conclusion Serum vaspin level significantly increases in subjects with obesity, and independently associated with gender, ISI,WHR. These findings suggest that serum Vaspin may be involved in the pathophysiology of insulin resistance syndrome.