摘要目的:探讨2型糖尿病（T2DM）患者糖化血红蛋白（HbA 1c）水平与左心室亚临床收缩功能的相关性。 方法:选取2021年6至12月连续就诊于空军军医大学第一附属医院内分泌科的T2DM患者。收集患者的年龄、心率、收缩压、空腹血糖（FPG）、HbA 1c、甘油三酯（TG）、尿微量白蛋白与肌酐比值（UACR）、左心室整体纵向应变（GLS）。依据GLS结果将研究对象分为T1（GLS≤16.6%）、T2（16.6%<GLS≤19.4%）、T3（GLS>19.4%）共3组。采用单因素方差分析、Fisher精确检验或 χ2检验、Kruskal-Wallis H检验比较组间临床特征和代谢指标的差异。采用Pearson相关分析法评价HbA 1c与GLS的相关性，采用线性回归分析法分析T2DM患者左心室亚临床心肌收缩功能障碍的影响因素。 结果:共纳入152例患者。其中，T1组51例，T2组51例，T3组50例。HbA 1c水平随着GLS高分位逐渐降低［（10.01±2.39）% vs（8.69±1.77）% vs（7.78±1.38）%， P<0.001］。Pearson相关分析法结果显示，HbA 1c与GLS呈负相关（ r=-0.48， P<0.001）。单因素线性回归分析结果显示，HbA 1c、年龄、心率、收缩压、FPG、TG、对数UACR均为左心室亚临床心肌收缩功能障碍的影响因素（均 P<0.05）；多因素线性回归分析结果显示，HbA 1c为GLS的独立影响因素（ β=-0.613， P<0.001），对数UACR是GLS降低的最强影响因素（ β=-1.010， P=0.024）。 结论:T2DM患者的HbA 1c与左心室亚临床收缩功能进展存在负相关，高UACR水平是左心室纵向心功能受损的主要影响因素。

abstractsObjective:To investigate the association between glycated hemoglobin A 1c (HbA 1c) and subclinical left ventricular (LV) systolic function in patients with type 2 diabetes mellitus (T2DM). Methods:T2DM patients who consecutively admitted to the Department of Endocrinology, First Affiliated Hospital of Air Force Medical University, Shaanxi Province from June to December 2021 were selected. The age, heart rate, systolic blood pressure, fasting plasma glucose (FPG), HbA 1c, triglyceride (TG) and urinary albumin to creatinine ratio (UACR), LV global longitudinal strain (GLS) were collected. According to the GLS results, patients were divided into three groups: T1 (GLS≤16.6%), T2 (16.6%<GLS≤19.4%), and T3 (GLS>19.4%). One-way analysis of variance, Fisher exact test or chi-square test, and Kruskal-Wallis H test were used to compare the differences in clinical characteristics and metabolic indexes among groups. Pearson correlation analysis was used to evaluate the correlation between HbA 1c and GLS, and multiple linear regression analysis was used to analyze the influencing factors of LV subclinical myocardial systolic dysfunction in patients with T2DM. Results:A total of 152 patients were included. There were 51 cases in T1 group, 51 cases in T2 group, and 50 cases in T3 group. HbA 1c level decreased with increasing GLS group [(10.01±2.39)% vs. (8.69±1.77)% vs. (7.78±1.38)%, P<0.001]. Pearson correlation analysis showed that HbA 1c was negatively correlated with GLS ( r=-0.48, P<0.001). The results of univariate linear regression analysis showed that HbA 1c, age, heart rate, systolic blood pressure, FPG, TG and UACR were significantly correlated with GLS (all P<0.05). Multivariate analysis showed that HbA 1c was independently associated with GLS ( β=-0.613, P<0.001). In addition, the results showed that logUACR was an independent and major risk factor for reduced GLS ( β=-1.010, P=0.024). Conclusions:HbA 1c was negatively associated with the progression of LV subclinical systolic function in patients with T2DM. High UACR level was the main influencing factor of LV longitudinal dysfunction.