2型糖尿病患者血糖波动与亚临床动脉粥样硬化的关系  

Study of the Relationship Between Blood Glucose Fluctuation and Subclinical Atherosclerosis in Type 2 Diabetes Mellitus

作　　者：何霞[1] 唐炜立[1] 周智广[1] 周启昌[2] 陈晓燕[1] 刘志文[1] 庞翠军[1] 

机构地区：[1]中南大学湘雅二医院代谢内分泌研究所,湖南省长沙市410011 [2]中南大学湘雅二医院超声诊断科,湖南省长沙市410011

出　　处：《中国动脉硬化杂志》2007年第10期759-762,共4页Chinese Journal of Arteriosclerosis

基　　金：国家"十五"科技攻关项目(2001BA702B01;2001BA702B04)

摘　　要：目的探讨2型糖尿病患者血糖波动与亚临床动脉粥样硬化的关系。方法170例年龄35～70岁、病程在1年以内、无亚临床动脉粥样硬化的2型糖尿病患者随机分为4组,分别给予不同的药物方案治疗。定期复查空腹血糖、早餐后2h血糖、糖化血红蛋白和血管彩色超声等指标,共随访3年。结果3年结束时,4组之间血糖波动指标比较差异无显著性(P>0.05),4个血糖波动指标的分层分析显示,亚临床动脉粥样硬化发生率均随血糖波动的增加而呈升高的趋势,尚未达到统计学差异。Logistic回归分析显示,亚临床动脉粥样硬化的发生与吸烟、高血脂、高龄、腹型肥胖、早餐后2h血糖与空腹血糖差值波动有关,而不同的干预方式对亚临床动脉粥样硬化的发生有影响(P<0.001)。结论早餐后2h血糖与空腹血糖差值波动大是2型糖尿病患者亚临床动脉粥样硬化的危险因素之一,吸烟、高血脂、高龄、腹型肥胖均是2型糖尿病患者亚临床动脉粥样硬化的危险因素。Aim To investigate the relationship between glucose fluctuation and subclinical atheresclerosis（As） in type 2 diabetic patients. Methods A random-eontrelled study was used, 170 type 2 diabetic patients （35 - 70 year-old, duration ≤ 1 year ） without As were randomly divided into 4 groups： group A, B, C and D. Each group was given different treatment. All patients accepted following-up once a month. Fasting blood sugar （FBS） and postprandial blood sugar （PBS） were measured after breakfast each time. Other metabolic variables were measured, including body mass index, waist circumference, glycosylated hemoglobin, plasma lipid, ultrasound measurement of the carotid and femoral artery intimal-medial thickness and plaque. Results Over three-year follow-up, data of four groups show no statistical difference in blood glucose fluctuation. Following blood glucose variation intensify, the morbidity of subclinical As increase. Logistic regression analysis show that the risk factors related to subclinical As are smoking, hyperlipemia history, age, WHR and PFSD. Conclusions The instable margin of PBS and FBS may be one of risk factors to subclinic atheroscleresis development in type 2 diabetic patiants. Smoking and hyperlipemia history, age, waist-to-hip ratio are all risk factors to subclinic atherosclerosis in type 2 diabetic patients.

关 键 词：内科学 2型糖尿病 干预方案 血糖波动 亚临床动脉粥样硬化 危险因素 动脉内膜中膜厚度 

分 类 号：R5[医药卫生—内科学]