性别对住院2型糖尿病患者心血管风险因素的影响分析  

Association of gender with cardiovascular disease risk factors in patients with type 2 diabetes mellitus

作　　者：严仍娜 陈慧梅[2] 马健[1] 杨翠华[1] 黄淼[1] 蒋荣[1] 张倩倩[1] 杜宏[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)内分泌科,南京医学硕士210002 [2]南京大学医学院医学遗传学研究室,南京210093

出　　处：《医学研究生学报》2014年第5期487-490,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81173622);江苏省自然科学基金(BK2011664)

摘　　要：目的已有研究表明,女性患者更易并发心血管疾病。文中分析性别因素对住院2型糖尿病(type 2 diabetes mellitus,T2DM)患者血糖、血脂、血压、尿微量白蛋白、肾小球滤过率等心血管危险因素水平的影响。方法选择2010年7月至2012年7月南京军区总医院内分泌科诊治的T2DM患者937例,收集患者临床资料,分析不同性别患者心血管危险因子达标率的差异,利用多因素logistic回归分析确定性别对T2DM患者心血管风险因素的影响。结果女性T2DM患者总胆固醇(total cholesterol,TC)、非高密度脂蛋白胆固醇(non-high density lipoprotein cholesterol,Non-HDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)和肾小球滤过率(estimated glomerular filtration,eGFR)达标率显著低于男性(P<0.01),利用多因素logistic回归分析校正年龄、病程、吸烟、体重指数(body mass index,BMI)等可能影响因素后,发现女性是TC、Non-HDL-C、HDL、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、eGFR不达标的独立危险因素,优势比(95%可信区间)分别为2.197(1.577,3.059)、1.945(1.391,2.720)、2.725(1.920,3.869)、1.760(1.254,2.471)和6.458(4.495,9.279)。结论女性是T2DM患者心血管危险因子(主要是血脂和eGFR)水平不达标的独立危险因素,在临床工作中应给予女性T2DM患者更多的教育和治疗。Objective Existing researches show that women with type 2 diabetes mullitus are incidented to cardiorascular diseases.This study is to investigate the association of gender with the risk factors of cardiovascular disease （CVD） in patients with type 2 diabetes mellitus.Methods We collected the clinical data of 937 cases of type 2 diabetes mellitus,analyzed the differences in the percentages of CVD risk factors between male and female patients,and assessed the influence of gender on CVD risk factors by multivariant logistic regression analysis.Results The on-target percentages of TC,non-HDL-C,HDL-C,and eGFR were significantly lower in the females than in the males （P 〈 0.01）.After the adjustment of such possible influencing factors of age,disease course,BMI,and cigarette smoking,female gender was associated with a significantly lower probability of achieving the norms of TC,non-HDL-C,HDL,LDL-C,and eGFR,with OR （95% CI） of 2.197 （1.577,3.059）,1.945 （1.391,2.720）,2.725 （1.920,3.869）,1.760 （1.254,2.471）,and 6.458 （4.495,9.279）,respectively.Conclusion In type 2 diabetic patients,female gender is an independent predictor of the abnormal levels of CVD risk factors,mainly cholesterol profile and eGFR.Diabetic women need more relevant education and treatment to be protected from CVD risk factors.

关 键 词：糖尿病 性别 心血管疾病 危险因素 

分 类 号：R587.1[医药卫生—内分泌]