糖尿病前期颈动脉内膜中层增厚的危险因素的分析  

Risk factor analysis of increase of the carotid artery intima-media in prediabetes

作　　者：于磊[1] 金国玺[1] 毕娅欣[1] 张士荣[1] 周静[1] 石彦[1] 

机构地区：[1]蚌埠医学院第一附属医院内分泌科,蚌埠233004

出　　处：《安徽医学》2013年第4期385-388,共4页Anhui Medical Journal

基　　金：安徽省卫生厅医学科研课题计划资助项目(09A014);安徽省教育厅自然科学研究资助项目(2003KJ264)

摘　　要：目的探讨糖尿病前期人群发生颈动脉内膜中层增厚的危险因素。方法研究对象来源于我院就诊和体检人员,包括正常人20例,空腹血糖受损28例,糖耐量异常40例,空腹血糖受损合并糖耐量异常32例。采集患者年龄、吸烟史、BMI等,并检测血糖、胰岛素、血脂、ET-1、NO等指标和彩色多普勒超声测定颈动脉内膜中层厚度。结果①IFG、IGT、IFG+IGT三组在年龄、BMI、DBP、FBG、PBG、FINS、TG的值均高于NGT组(P<0.05),IFG+IGT在年龄上高于IFG和IGT组(P<0.05)。②IFG、IGT、IFG+IGT三组的IMT、ET-1、NO值均高于NGT组(P<0.05),IGT与IFG相比ET-1差异有统计学意义(P<0.05),IFG+IGT组与IFG组相比ET-1、NO两项指标差异有统计学意义(P<0.05)。③单因素Logistic回归分析提示,发生IGT以及IFG+IGT、年龄、性别、吸烟、BMI、收缩压、舒张压、空腹胰岛素、TC、TG、ET-1、NO都和颈动脉内膜中层增厚的发生呈正相关(P<0.05),多因素Logistic分析显示,颈动脉内膜中层增厚的独立危险因素是:年龄、PBG、TG、ET-1、和吸烟。结论糖尿病前期人群戒烟、严格控制血脂、血糖对大血管病变的预防有重要意义。Objective To discuss the risk factors of the thickening of the carotid artery intima - media in prediabetes. Methods The object of the study came from our patients and medical personnel, including 20 cases of normal（ NGT）, 28 cases of impaired fasting glu- cose（ IFG）, 40 cases of impaired glucose tolerance （IGT）, and 32 cases of impaired fasting glucose combined impaired glucose tolerance （IFG ＋ IGT）. Patientg, ages, smoking histories and so on were collected, and blood glucose, BMI, insulin, blood lipid, ET - 1 and NO were tested, along with color Doppler ultrasound used to detect the carotid intima - media thickness. Results ① Age, BMI, DBP, FBG, PBG, FINS, TG in the three groups of IFG, IGT, IFG ＋ IGT were significantly higer than those in the group of NGT（ P 〈 0.05 ） ; age in IFG ＋ IGT group was significantly higher than that in the groupof IFG and IGT（P 〈 0.05 ）. ②The levels of IMT, ET - 1, NO in the three groups of IFG, IGT, IFG ＋ IGT were significantly higer than those in the group of NGT（P 〈 0.05）, the level of ET - 1 in the groups of IGT and IFG had significant difference （P 〈 O. 05 ）, and the levels of ET - 1 and NO in the group of IFG, IFG ＋ IGT had significant difference （ P 〈 O. 05 ）. ③Single fator logistic regression analysis pointed out that occurrences of IGT and IFG ＋ IGT, age, gender, smoking, BMI, SBP, DBP, fasting insulin, TG, TC, ET - 1, NO were positively correlated with the thicking of the carotid intima - media （P 〈 0.05 ）. Mutiple fators lo- gistic analysis showed that age, PBG, TG, ET - 1 and smoking were the independent risk fators of the carotid intima - media thickness in- crease. Conclusion It is significant for prediabetes to give up smoking, strictly control the blood lipid, especially triglycerides and blood glucose.

关 键 词：糖尿病前期 大血管病变 颈动脉内膜中层厚度 LOGISTIC回归分析 

分 类 号：R587.1[医药卫生—内分泌]