糖尿病前期是在正常血糖与糖尿病(diabetes mellitus, DM)之间的中间高血糖状态,该人群较糖尿病患者数量更为庞大,发生心血管事件总数更多。糖尿病前期与心血管疾病(cardiovascular disease,CVD)的风险增加相关,但干预糖尿病前期能否带来微血管和大血管的长期获益尚存争议。糖化血红蛋白(glycated hemoglobin A1c, HbA1c)不仅是诊断糖代谢异常的指标, 还是监测血糖状态的连续指标,其水平升高与心血管病变关系密切。本文就HbA1c 在糖尿病前期和CVD的相关性作一综述,以揭示HbA1c 可作为评估非糖尿病人群心血管风险的综合指标,低于DM 阈值的HbA1c 可对心血管风险进行分层,可能为当前和未来的CVD预防策略提供信息。

Prediabetes is an intermediate state of hyperglycemia between normoglycemia and diabetes mellitus (DM), with a larger population affected compared to patients with diabetes and a higher incidence of cardiovascular events. Prediabetes is associated with an increased risk of cardiovascular disease (CVD); however, the long-term benefits of intervening in prediabetes on microvascular and macrovascular outcomes remain controversial. Glycated hemoglobin (HbA1c) serves as not only a diagnostic indicator of abnormal glucose metabolism, but also a fundamental biomarker for continuous glucose monitoring, with its elevated levels closely related to cardiovascular diseases. This article reviews the association between HbA1c, prediabetes, and CVD, aiming to elucidate the utility of HbA1c as a composite indicator for assessing cardiovascular risk in non-diabetic populations. Furthermore, HbA1c below the threshold for diabetes can stratify cardiovascular risk, thereby offering valuable information for current and future strategies in the prevention of CVD.