颈动脉内膜中层厚度在尿白蛋白正常的不同糖耐量人群中的变化及相关危险因素探讨  

Carotid arterial intima-media thickness in subjects with normal urinary albumin excretion at different status of glucose tolerance

作　　者：唐菊英[1] 刘丹[1] 严励[1] 文艳玲[1] 肖辉盛[1] 黎锋[1] 程桦[1] 

机构地区：[1]中山大学孙逸仙纪念医院内分泌科,广州510120

出　　处：《中华临床医师杂志（电子版）》2011年第4期67-70,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家十一五攻关课题(2006BAI02B08)

摘　　要：目的观察尿白蛋白排泄率(AER)在临床正常值范围内的不同糖耐量人群颈动脉内膜中层厚度(IMT)变化情况并分析其相关危险因素。方法选取AER在临床正常值范围内的正常糖耐量(NGT)25例、糖耐量减低(IGT)29例和新诊断2型糖尿病(T2DM)163例受试者,检测其颈动脉IMT及分析相关心血管危险因素。结果 T2DM组患者AER较非糖尿病组高(P<0.001);其颈动脉IMT比NGT组厚(P=0.03)。IGT组患者异常颈动脉IMT与空腹血糖正相关,调整了年龄和性别因素影响后相关性依然良好(r=0.461,P=0.020);空腹血糖升高致其发生异常颈动脉IMT的优势比(OR)达8.06(95%CI1.09～59.49)。结论 T2DM患者AER较非糖尿病患者高,且已出现亚临床性心血管疾病。IGT患者的空腹血糖水平与异常颈动脉IMT的发生独立相关,可作为心血管疾病危险预测因子。Objective To investigate carotid arterial intima-media thickness （IMT） in subjects with normal urinary albumin excretion rate （AER） at different status of glucose tolerance, and assess the relationships between carotid IMT and conventional cardiovascular risk factors. Methods The ultrasound measurements of carotid IMT were performed and conventional cardiovascular risk factors, including age, sex, hyperglycemia and lipids profile, were analyzed in the subjects with normal AER at the status of normal glucose tolerance （ NGT, n = 25 ） or impaired glucose tolerance （ IGT, n = 29） or newly diagnosed type 2 diabetes mellitus （T2DM, n = 163 ）. Results AER increased significantly in T2DM patients with comparison of that in non-diabetic patients（ P 〈 0. 001 ）. The carotid IMT of T2DM patients were higher than that of NGT subjects （P = 0. 03 ）. Adjusting for age and gender, the abnormalities of carotid IMT in the IGT individuals was positively correlated with fasting plasma glucose （FPG） level （r = 0. 461, P = 0. 020）. Odds ratio of the abnormalities of carotid IMT amounted to 8.06 （95% CI 1.09-59.49）for a one unit increase in FPG. Conclusions T2DM patients had a substantial increase of AER within the normal clinical range, and thus indicated the presence of subclinical cardiovascular diseases. In IGT individuals within normal AER range, FPG level was significantly and independently correlated with the abnormalities of carotid IMT, and might be an important risk predictor for cardiovascular diseases.

关 键 词：糖尿病 2型 危险因素 颈动脉内膜中层厚度 糖耐量减低 

分 类 号：R543[医药卫生—心血管疾病]