Correlation Between Glycated Hemoglobin Index And Diabetic Cardiovascular Autonomic Neuropathy

ObjectiveTo explore the correlation between hemoglobin glycosylation index(HGI)and diabetic cardiovascular autonomic neuropathy(DCAN)in patients with type 2 diabetes.MethodsThis study was a Cross-sectional study.993 patients with type 2diabetes who were hospitalized in the Endocrinology Department of the First Affiliated Hospital of Chongqing Medical University from October2017 to May 2020 were selected as the research objects.The patients′gender,age,family history of diabetes,diabetes duration,systolic blood pressure and diastolic blood pressure,body mass index(BMI),fasting plasma glucose(FPG),glycated hemoglobin A1c(Hb A1c),blood lipids,hypersensitive C-reactive protein(hs-CRP),serum creatinine,urinary albumin creatinine ratio(UACR)and estimated glomerular filtration rate(e GFR)were collected.Based on FPG and Hb A1 c,a linear regression equation was established and HGI was calculated.According to the HGI value,the patients were divided into three groups: low-HGI(L-HGI)group,medium-HGI(M-HGI)group,high-HGI(H-HGI)group using the three-quantile method.One-way analysis of variance(ANOVA)and chi-square test were employed to analyze the differences of baseline data among three groups,multivariate logistic regression was used to analyze the risk factors of DCAN.ResultsAmong the 993 patients with type 2 diabetes,there were 293 patients in the DCAN group and 700 patients in the non-DCAN(N-DCAN)group,and the prevalence of DCAN was 29.5%(293/993).The prevalence of DCAN in L-HGI group(331 cases),M-HGI group(331 cases),and H-HGI group(331 cases)was 15.1%(50/331),28.7%(95/331)and 44.7%(148/331)respectively.The prevalence of DCAN increased with the increase of HGI level,and the difference between the three groups was statistically significant(χ~2=69.50,P<0.01).The risk of DCAN in H-HGI group was 4.545 times higher than that in L-HGI group [95% confidence interval(CI)3.137 to 6.585,P<0.05],and the risk of DCAN in M-HGI group was 2.262 times higher than that in L-HGI(95%CI 1.541 to 3.320,P<0.05).Logistic regression analysis showed that the prevalence of DCAN increased with the increase of HGI [odds ratio was 1.445(95%CI 1.281 to1.629),P<0.01].After adjusting for age,family history of diabetes,FPG,hs-CRP,UACR>30 mg/g,e GFR,BMI,hypertension,and dyslipidemia,HGI was an independent risk factor for DCAN(odds ratio was 1.578(95%CI 1.378 to 1.808),P<0.01].ConclusionsHGI is closely related to the onset of the type 2 diabetes with DCAN.Patients with high HGI have an increased risk of DCAN.