高嘌呤饮食的2型糖尿病患者心血管并发症危险因素分析  

Risk Factors of Cardiovascular Complications among Type 2 Diabetes Mellitus Patients on High-Purine Diet

作　　者：王丽君[1] 金都[1] 涂传发 杨宏伟[1] 顾琴红[1] 

机构地区：[1]浙江省台州市第一人民医院内分泌科,318020

出　　处：《中国全科医学》2011年第26期2962-2964,共3页Chinese General Practice

摘　　要：目的探讨高嘌呤饮食的2型糖尿病(T2DM)患者心血管并发症的危险因素。方法将268例高嘌呤饮食的T2DM患者分为T2DM非心血管并发症组和T2DM心血管并发症组,另选择80例体检健康者作为对照组。比较各组血尿酸、血脂(总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白)、空腹血糖、体质指数、病程和血压的差异,并对T2DM心血管并发症组和T2DM非心血管并发症组有统计学差异的指标进行Logistic回归分析,探讨T2DM心血管并发症的危险因素。结果高嘌呤饮食的T2DM患者心血管并发症的发病率为53.73%(144/268)。T2DM心血管并发症组、T2DM非心血管并发症组患者的体质指数、收缩压、舒张压、血尿酸、空腹血糖、三酰甘油及低密度脂蛋白均显著高于对照组,差异有统计学意义(P<0.05);T2DM心血管并发症组较非心血管并发症组血尿酸及低密度脂蛋白水平高、收缩压高、病程长,差异有统计学意义(P<0.05)。Logistic回归分析显示:病程、收缩压和血尿酸是T2DM心血管并发症的危险因素(P<0.05)。结论血尿酸是T2DM心血管并发症的危险因素,可能与其嘌呤代谢异常有关,与嘌呤类饮食摄入过多无关。病程和收缩压亦是T2DM心血管并发症的独立危险因素。Objective To explore the risk factors of cardiovascular complications in type 2 diabetes mellitus （T2DM） patients on high purine diet. Methods A total of 268 high purine diet T2DM patients were divided into the cardiovascular compli- cation group and the non - cardiovascular complication group. Another 80 healthy subjects were enrolled as controls. Cholesterol, glycerin trilaurate, high density lipoprotein, low density lipoprotein, blood uric acid, fasting blood - glucose, body mass in- dex, course of disease and blood pressure were compared between the three groups, with logistic regression analysis performed on indices statistically different between the cardiovascular complication group and the non - cardiovascular complication group. Results The incidence rate of cardiovascular complications among T2DM patients on high purine diet is 53.73% （ 144/ 268） . Glycerin trilaurate, blood uric acid, fasting blood - glucose, low density lipoprotein, body mass index, and blood pres-sure were significantly higher in the cardiovascular complication group and the non - cardiovascular complication group than in the control group （ P 〈 0. 05 ） . The cardiovascular complication group showed higher blood uric acid levels, higher low density lipo- protein levels, higher systolic pressure and longer disease course compared with the non - cardiovascular complication group （ P 〈 0. 05） . Logistic regression analysis revealed that uric acid levels, systolic pressure, and disease course were risk factors for cardiovascular complications among T2DM patients （ P 〈 0. 05 ） . Conclusion Blood uric acid level, systolic pressure and course of disease are independent risk factors of cardiovascular complications in T2DM patients. Blood uric acid level is possibly caused by metabolic abnormality of purioe and is not associated with high purine intake.

关 键 词：糖尿病 2型 饮食习惯 嘌呤类 尿酸 心血管疾病 危险因素 

分 类 号：R587.23[医药卫生—内分泌]