机构地区:[1]武汉大学中南医院内分泌科,武汉430071 [2]武汉大学中南医院综合科,武汉430071
出 处:《中国医师杂志》2015年第1期61-64,共4页Journal of Chinese Physician
摘 要:目的探讨低度炎症反应在男性2型糖尿病(T2DM)患者血浆睾酮(T)与颈动脉内膜中层厚度(CIMT)相关性中的作用。方法共纳入247例既往无冠心病(CHD)病史的成年男性T2DM患者,按照血浆C反应蛋白(CRP)及T浓度分为低度炎症低T组(LI—LT,CRP≥2.0mg/L,T〈12.0nmol/L,n=65),低度炎症正常T组(LI-NT,n=67),非低度炎症低T组(NLI.LT,n=56)及非低度炎症正常T组(NLI-NT,n=59)。收集一般资料、主要病史、人体测量学指标等,检测糖化血红蛋白(HbA1c)、血脂谱及CIMT。结果与NLI—NT组相比,NLI—LT组CIMT有所增加,但差异无统计学意义[(0.87±0.09)vs(0.90±0.10)mm,t=1.693,P:0.090];与LI-NT组相比,LI-LT组患者CIMT显著增加[(0.99±0.10)vs(1.07±0.12)mm,t=5.208,P=0.000]。整体血浆T与CIMT呈显著负相关(n=247,r=-0.368,P:0.000),低度炎症患者中也呈显著负相关(n=132,r=-0.582,P=0.000),非低度炎症患者中无显著性相关(n=115,r=-0.098,P=0.087)。以CI—MT为因变量,血浆T为自变量,在校正年龄、吸烟、病程、家族史、体质量、血压、HbA1c及血脂谱等因素前后,其偏回归系数分别为-0.062(95%CI:-0.094--0.029,P=0.008),-0.045(95%CI:-0.087--0.002,P=0.036);校正CRP后,其偏回归系数为-0.019(95%CI:-0.120-0.042,P:0.287)。结论男性T2DM患者血浆T与CIMT负相关,低度炎症反应可能对该相关性具有调节作用。Objective To investigate the impacts of low-grade inflammation On the correlation of serum testosterone (T) and carotid intima-media thickness (CIMT) in type 2 diabetes mellitus (T2DM) men. Methods Based on the concentration of C-reactive protein (CRP) and T, a total of 247 patients was divided into low-grade inflammation with low T group ( LI-LT, CRP ≥ 2. 0 mg/L, T 〈 12. 0 nmol/L, n = 65), low-grade inflammation with normal T group (LI-NT, n = 67 ), non-tow-grade inflammation with low T group ( NLI-LT, n = 56 ) , and non-low-grade inflammation with normal T group ( NLI-NT, n = 59). General information, medical history, and anthropometry data were collected. Glycosylated hemoglobin Ale (HbA1c), blood fat, and CIMT were detected. Results Compared to NLI-NT group, CIMT in NLI-LT group was increased without statistical significance [(0. 87±0. 09) vs (0. 90±0. 10)mm, t = 1. 693, P = 0. 090 ]. CIMT in LI-LT group was increased significantly compared to that of LI-NT group [ (0. 99±0. 10) vs (1.07 ± 0. 12)mm, t = 5. 208, P = 0. 000 ]. Correlation analysis indicated that serum T correlated nega- tively with CIMT ( n =247; r = -0. 368, P 〈0. 01) in whole. The correlation coefficient oft and CIMT was -0. 582 ( P =0. 000), and -0. 098 ( P =0. 087) in patients with ( n = 132) and without ( n = 115 ) low-grade inflammation, respectively. To make CIMT dependent coefficient and serum T independent coefficient in multiple regression analysis, the partial regression coefficient was -0. 062 (95% CI: - 0. 094 - -0. 029, P =0. 008) , and -0. 045 (95% CI : -0. 087 - -0. 002, P =0. 036) , respectively, before and after the adjustment of age, smoking, family history, T2DM course, body mass, blood pressure, HbAlc, and blood fat. After the additional adjustment of CRP, the partial regression coefficient was - 0. 019(95% CI : -0. 120 -0. 042, P =0. 287). Conclusions The negative relationship between serum T and CIMT in T2DM men might be m
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