BACKGROUND Glycosylated hemoglobin (HbA1c) has a detrimental impact on the myocardium with left ventricular (LV) diastolic dysfunction. Obesity is a risk factor of type 2 diabetes. To understand the relationships between HbA1c, body mass index (BMI) and LV diastolic dysfunction, we performed this interaction analysis in patients with type 2 diabetes. METHODS Total 925 type 2 diabetes patients were selected from the patients who were diagnosed and treated at the First Affiliated Hospital of Shenzhen University. Patients' BMI levels were defined as normal (BMI < 24 kg/m2) and overweight /obese (BMI ≥ 24 kg/m2). Patients' HbA1c levels were grouped as HbA1c ≥ 9%、7% ≤ HbA1c < 9% and HbA1c < 7%. Logistic regression, stratified, interaction analysis, multivariate Cox regression and curve fitting analysis were performed to investigate the correlations and interactions between HbA1c and BMI with LV diastolic dysfunction. RESULTS The BMI levels were significantly associated with LV diastolic dysfunction in the patients with type 2 diabetes [adjusted model: 1.12 (1.05, 1.20), P = 0.001]. While HbA1c levels had association with LV diastolic dysfunction only in normal BMI group patients [adjusted model: 1.14 (1.01, 1.30), P = 0.0394] and curve correlation was observed. There was a significant interaction between BMI and HbA1c to affect LV diastolic dysfunction (P = 0.0335). Cox regression model analysis showed that the risk of LV diastolic dysfunction was a U type correlation with HbA1c levels in the normal weight group and the turning point was HbA1c at 10%. HbA1c level was not found to have a significant association with LV diastolic dysfunction in overweight/obese group. CONCLUSIONS In patients with type 2 diabetes, correlation between LV diastolic dysfunction and HbA1c was interactively affected by BMI. Glycemic control is beneficial to the heart function in normal body weight patients. For overweight/obese patients, the risk of LV diastolic dysfunction was not determined by the HbA1c level, indicating it may be affected by other confounding factors.

中文翻译：

---

深入分析2型糖尿病患者的糖基化血红蛋白水平，体重指数和左心室舒张功能障碍。

背景技术糖基化血红蛋白（HbA1c）对具有左心室（LV）舒张功能障碍的心肌有不利影响。肥胖是2型糖尿病的危险因素。为了了解HbA1c，体重指数（BMI）和LV舒张功能障碍之间的关系，我们对2型糖尿病患者进行了这种相互作用分析。方法从深圳大学第一附属医院确诊并治疗的2型糖尿病患者共925例。患者的BMI水平定义为正常（BMI <24 kg / m2）和超重/肥胖（BMI≥24 kg / m2）。患者的HbA1c水平分为HbA1c≥9％，7％≤HbA1c<9％和HbA1c <7％。Logistic回归，分层，交互分析，进行多元Cox回归和曲线拟合分析，研究HbA1c和BMI与LV舒张功能障碍之间的相关性和相互作用。结果2型糖尿病患者的BMI水平与LV舒张功能异常显着相关[调整后的模型：1.12（1.05，1.20），P = 0.001]。虽然仅在正常BMI组患者中HbA1c水平与LV舒张功能障碍有关[调整模型：1.14（1.01，1.30），P = 0.0394]，并且观察到曲线相关性。BMI和HbA1c之间存在显着的相互作用，从而影响LV舒张功能障碍（P = 0.0335）。Cox回归模型分析表明，正常体重组左室舒张功能障碍的风险与HbA1c水平呈U型相关，转折点为HbA1c为10％。在超重/肥胖组中，未发现HbA1c水平与LV舒张功能障碍有显着相关性。结论在2型糖尿病患者中，BMI交互影响左室舒张功能障碍与HbA1c之间的相关性。血糖控制对正常体重患者的心脏功能有益。对于超重/肥胖患者，左心室舒张功能障碍的风险不是由HbA1c水平决定的，这表明它可能受到其他混杂因素的影响。