Association of Glycated Albumin and Glycated Hemoglobin with Aortic Valve Calcification in Moderate and Severe Valvular Heart Disease Patients

doi:10.12114/j.issn.1007-957.2024.0502

Abstract

Abstract:

Background

Aortic valve calcification (AVC) is a common aortic valve disease and a common manifestation of cardiovascular disease. Glycated albumin and glycated hemoglobin are closely related to the occurrence and development of cardiovascular diseases, but the relationship between them and AVC in patients with aortic valve disease remains unclear.

Objective

To investigate the association of glycated albumin and glycated hemoglobin with AVC.

Methods

A total of 237 patients with AVC who were hospitalized in The Second Affiliated Hospital of Soochow University and The Fourth Affiliated Hospital of Soochow University from January 2015 to January 2023 were retrospectively enrolled as research subjects, who were divided into calcification group (188 cases) and non-calcification group (49 cases) according to the CT evaluation results. Indicators such as glycated albumin, glycated hemoglobin, fasting blood glucose as well as the regular information were recorded. Multivariate Logistic regression analysis was adopted to evaluate the influencing factors of AVC. Subject operating characteristics (ROC) curve was used to evaluate the predictive value of glycated albumin and glycated hemoglobin for AVC, and calculate the area under ROC curve (AUC).

Results

Glycated albumin, glycated hemoglobin, and fasting blood glucose levels were higher in patients of the calcification group than the non-calcification group, the difference was statistically significant (P<0.05). The results of multifactorial Logistic regression analysis showed that age and fasting blood glucose were independent influencing factors for AVC (P<0.05). The results of ROC curve analysis showed that the AUC value of glycated albumin for predicting AVC was 0.620 (95%CI=0.529-0.711), with an optimal cut-off value of 15.85%, a sensitivity of 0.559 and a specificity of 0.694. Glycated hemoglobin predicted AVC with an AUC value of 0.609 (95%CI=0.522-0.696), an optimal cutoff value of 6.15%, a sensitivity of 0.431, and a specificity of 0.796.

Conclusion

Glycated albumin and glycated hemoglobin are not independent influencing factors for the development of AVC in patients with moderate and severe aortic valve disease, and they have limited predictive value for AVC occurrence in this patient population, but can serve as auxiliary reference indicators in clinical practice.

Key words: Aortic valve calcification, Glycated albumin, Glycated hemoglobin, Blood glucose

摘要：

背景

主动脉瓣钙化（AVC）是一种常见的主动脉瓣膜病变，属于心血管疾病常见的表现形式。糖化白蛋白和糖化血红蛋白与心血管疾病的发生发展密切相关，但二者与主动脉瓣疾病患者AVC的关系尚不明确。

目的

探讨糖化白蛋白和糖化血红蛋白与AVC的关系。

方法

回顾性纳入2015年1月—2023年1月于苏州大学附属第二医院和苏州大学附属第四医院住院治疗的237例主动脉瓣疾病患者为研究对象，根据CT评估结果将患者分为钙化组（188例）和无钙化组（49例）。收集患者一般资料以及糖化白蛋白、糖化血红蛋白、空腹血糖等实验室检查指标，比较两组患者一般资料和实验室检查指标的差异，采用多因素Logistic回归分析评估AVC的影响因素。采用受试者工作特征（ROC）曲线评估糖化白蛋白和糖化血红蛋白预测AVC的价值，并计算ROC曲线下面积（AUC）。

结果

钙化组患者糖化白蛋白、糖化血红蛋白、空腹血糖水平高于无钙化组（P<0.05）；多因素Logistic回归分析结果显示，年龄和空腹血糖是AVC的独立影响因素（P<0.05）。ROC曲线分析结果显示，糖化白蛋白预测AVC的AUC值为0.620（95%CI=0.529~0.711），最佳截断值为15.85%，灵敏度为0.559，特异度为0.694。糖化血红蛋白预测AVC的AUC值为0.609（95%CI=0.522~0.696），最佳截断值为6.15%，灵敏度为0.431，特异度为0.796。

结论

糖化白蛋白、糖化血红蛋白不是中重度主动脉瓣疾病患者发生AVC的独立影响因素，对中重度主动脉瓣疾病患者发生AVC的预测价值有限，但可作为临床辅助参考指标。

关键词: 主动脉瓣钙化, 糖化白蛋白, 糖化血红蛋白, 血糖

ZHANG Junyang,ZENG Yiyao,JIN Fulu, et al. Association of Glycated Albumin and Glycated Hemoglobin with Aortic Valve Calcification in Moderate and Severe Valvular Heart Disease Patients[J]. Chinese General Practice, 2026, 29(08): 1008-1012. DOI: 10.12114/j.issn.1007-957.2024.0502.
张钧阳,曾钇尧,金富璐等. 糖化白蛋白和糖化血红蛋白与中重度主动脉瓣疾病患者主动脉瓣钙化的关系研究[J]. 中国全科医学, 2026, 29(08): 1008-1012. DOI: 10.12114/j.issn.1007-957.2024.0502.

Figures/Tables 4

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组别	例数	性别[例（%）]		年龄（±s，岁）	吸烟[例（%）]		高血压病史[例（%）]		糖尿病病史[例（%）]		BMI（±s，kg/m²）	冠状动脉钙化[例（%）]
组别	例数	男	女	年龄（±s，岁）	有	无	有	无	有	无	BMI（±s，kg/m²）	有	无
无钙化组	49	36（73.5）	13（26.5）	70.9±8.9	6（12.2）	43（87.8）	31（63.3）	18（36.7）	6（12.2）	43（87.8）	24.3±4.5	28（57.1）	21（42.9）
钙化组	188	117（6.2）	71（37.8）	75.2±8.0	25（12.3）	163（86.7）	108（57.4）	80（42.6）	43（22.9）	145（77.1）	23.9±2.8	145（77.1）	43（22.9）
检验统计量值		2.144^a		-3.293^b	0.038^a		0.543^a		2.677^a		0.389^b	7.875^a
P值		0.180		0.001	0.846		0.517		0.116		0.699	0.007
组别	糖化白蛋白（±s，%）	糖化血红蛋白（±s，%）	白蛋白（±s，g/L）	空腹血糖（±s，mmol/L）	三酰甘油[M（P₂₅，P₇₅），mmol/L]	总胆固醇（±s，mmol/L）	LDL-C（±s，mmol/L）	HDL-C（±s，mmol/L）	血尿素氮[M（P₂₅，P₇₅），mmol/L]	血肌酐[M（P₂₅，P₇₅），mmol/L]	血尿酸（±s，μmol/L）
无钙化组	15.7±2.8	5.88±0.69	39.1±3.5	5.46±1.83	1.16（0.81，1.62）	3.91±1.29	2.13±1.09	1.20±0.31	7.5（6.6，9.5）	98.0（80.5，117.5）	443.5±144.6
钙化组	16.8±3.0	6.17±0.91	39.9±4.3	6.65±0.26	1.21（0.86，1.77）	3.89±0.99	2.02±0.83	1.20±0.38	7.3（6.0，10.3）	90.0（74.8，108.0）	419.6±141.3
检验统计量值	-2.049^b	-2.152^b	-1.304^b	-0.806^b	-0.896	0.161^b	0.778^b	-0.087^b	0.690	1.443	1.048^b
P值	0.042	0.032	0.193	<0.001	0.370	0.872	0.437	0.930	0.490	0.149	0.296

组别	例数	性别[例（%）]		年龄（±s，岁）	吸烟[例（%）]		高血压病史[例（%）]		糖尿病病史[例（%）]		BMI（±s，kg/m²）	冠状动脉钙化[例（%）]
组别	例数	男	女	年龄（±s，岁）	有	无	有	无	有	无	BMI（±s，kg/m²）	有	无
无钙化组	49	36（73.5）	13（26.5）	70.9±8.9	6（12.2）	43（87.8）	31（63.3）	18（36.7）	6（12.2）	43（87.8）	24.3±4.5	28（57.1）	21（42.9）
钙化组	188	117（6.2）	71（37.8）	75.2±8.0	25（12.3）	163（86.7）	108（57.4）	80（42.6）	43（22.9）	145（77.1）	23.9±2.8	145（77.1）	43（22.9）
检验统计量值		2.144^a		-3.293^b	0.038^a		0.543^a		2.677^a		0.389^b	7.875^a
P值		0.180		0.001	0.846		0.517		0.116		0.699	0.007
组别	糖化白蛋白（±s，%）	糖化血红蛋白（±s，%）	白蛋白（±s，g/L）	空腹血糖（±s，mmol/L）	三酰甘油[M（P₂₅，P₇₅），mmol/L]	总胆固醇（±s，mmol/L）	LDL-C（±s，mmol/L）	HDL-C（±s，mmol/L）	血尿素氮[M（P₂₅，P₇₅），mmol/L]	血肌酐[M（P₂₅，P₇₅），mmol/L]	血尿酸（±s，μmol/L）
无钙化组	15.7±2.8	5.88±0.69	39.1±3.5	5.46±1.83	1.16（0.81，1.62）	3.91±1.29	2.13±1.09	1.20±0.31	7.5（6.6，9.5）	98.0（80.5，117.5）	443.5±144.6
钙化组	16.8±3.0	6.17±0.91	39.9±4.3	6.65±0.26	1.21（0.86，1.77）	3.89±0.99	2.02±0.83	1.20±0.38	7.3（6.0，10.3）	90.0（74.8，108.0）	419.6±141.3
检验统计量值	-2.049^b	-2.152^b	-1.304^b	-0.806^b	-0.896	0.161^b	0.778^b	-0.087^b	0.690	1.443	1.048^b
P值	0.042	0.032	0.193	<0.001	0.370	0.872	0.437	0.930	0.490	0.149	0.296

变量	B	SE	Wald χ²值	P值	OR值	95%CI
年龄	0.061	0.019	9.811	0.002	1.063	1.023~1.104
糖化白蛋白	0.135	0.064	4.465	0.035	1.145	1.010~1.298
糖化血红蛋白	0.444	0.220	4.052	0.044	1.559	1.012~2.401
空腹血糖	0.420	0.131	10.303	0.001	1.522	1.178~1.967
冠状动脉钙化	0.928	0.337	7.586	0.006	2.529	1.307~4.895

变量	B	SE	Wald χ²值	P值	OR值	95%CI
年龄	0.061	0.019	9.811	0.002	1.063	1.023~1.104
糖化白蛋白	0.135	0.064	4.465	0.035	1.145	1.010~1.298
糖化血红蛋白	0.444	0.220	4.052	0.044	1.559	1.012~2.401
空腹血糖	0.420	0.131	10.303	0.001	1.522	1.178~1.967
冠状动脉钙化	0.928	0.337	7.586	0.006	2.529	1.307~4.895

变量	B	SE	Wald χ²值	P值	OR值	95%CI
年龄	0.058	0.020	8.298	0.004	1.060	1.019~1.103
空腹血糖	0.391	0.130	9.097	0.003	1.478	1.147~1.906