The effect of different grading glycosylated hemoglobin on carotid artery endothelial cells in diabetic patients / 中国医师进修杂志

ABSTRACT

Objective To study the effect of different grading glycosylated hemoglobin(HbA1c) on carotid artery endothelial cells in diabetic patients.Methods A total of 120 patients with type 2 diabetes mellitus patients were divided into 4 groups according to the different levels of HbA1c6％ ≤HbA1c ＜ 7％ as group 1 (30 cases),7％ ≤HbA1c ＜ 8％ as group 2(31 cases),8％ ≤HbA1c ＜ 9％ as group 3(29 cases) and HbA1c ≥ 9％ as group 4 (30 cases).The indicators of endothelial function and carotid ultrasonography were detected and recorded.Results There was significant difference in endothelin-1 (ET-1) and nitric oxide (NO) among 4 groups (P ＜ 0.01).When compared between 2 groups,ET-1 and NO in group 4 was the highest [(89.3 ± 19.2) ng/L,(59.5 ± 9.3) μ mol/L],next was group 3 [(85.9 ± 16.4) ng/L,(56.4 ± 8.9)μ mol/L] and group 2[(83.4 ± 17.3) ng/L,(52.3 ± 8.3) μ mol/L],and there was significant difference (P ＜0.05).There was significant difference in carotid intima-mild thickness (IMT) among 4 groups (P ＜ 0.01).When compared between two groups,IMT in group 4 was the biggest [(2.90 ± 0.62) mm],next was group 3 [(2.40 ± 0.73)mm] and group 2[(1.90 ± 0.42) mm],and there was significant difference(P ＜ 0.05).There was significant difference in the incidence of carotid plaque among 4 groups (P ＜ 0.01).When compared between 2 groups,the incidence of carotid plaque in group 4 was the highest [93.3％(28/30)],next was group 3 [79.3％(23/29)]and group 2 [61.3％ (19/31)],and there was significant difference(P ＜ 0.05).There was significant difference in the type of carotid plaque among 4 groups (2 =51.10,P ＜ 0.01).HbA1c was correlated with the type of carotid plaque (r =0.56,P ＜0.01).Conclusion For patients with type 2 diabetes,there is a strong link between plaque,HbA1c level and carotid artery endothelial cells.