新诊断早发2型糖尿病心脑血管疾病风险分析  

Risk analysis of cardiovascular and cerebrovascular disease in new diagnosed with early onset type 2 diabetes

作　　者：林珊珊[1] 郭丽敏[1] 佘其美[1] 杨雪梅[1] 田应芳[1] 

机构地区：[1]首都医科大学石景山教学医院北京市石景山医院内分泌科,北京100043

出　　处：《中国当代医药》2016年第20期56-59,共4页China Modern Medicine

摘　　要：目的 探讨新诊断早发2型糖尿病患者的血脂、血压、血尿酸（UA）、高敏C反应蛋白（hs-CRP）、胰岛功能及胰岛素抵抗等临床情况。方法 选取2014年1月-2015年12月在本院住院且临床资料完全的177例新诊断2型糖尿病患者作为研究对象,其中早发组（≤40岁）63例,对照组（年龄41-59岁）114例。比较两组的血脂、血压、肝肾功能、UA、hs-CRP、胰岛功能及胰岛素抵抗等临床情况,探讨新诊断早发2型糖尿病是否有更高的心脑血管风险可能。结果 早发组的TC、TG、eGFR、UA、hs-CRP、DBP、HOMA-IR水平高于对照组,HDL-C水平低于对照组,差异有统计学意义（P〈0.05）。两组的LDL-C、Cr、ALT、AST、SBP、空腹血糖、HbA1c、糖化白蛋白及HOMA-IS水平比较,差异无统计学意义（P〉0.05）。早发组的年龄、腰围、臀围、BMI值显著高于对照组,差异有统计学意义（P〈0.05）。Pearson相关分析显示,BMI与TG、HOMA-IR、UA呈正相关,与年龄呈负相关。TG与TC、hs-CRP、HOMAIR、DBP、UA、BMI呈正相关,与HDL-C呈负相关。结论 早发2型糖尿病有更高的心脑血管病的风险,在积极降血糖的同时,应加强对血脂紊乱、高血压、高尿酸血症、胰岛素抵抗的改善,以预防大血管病变。Objective To explore the clinical situation of blood fat,blood pressure,blood uric acid （UA）,high sensitive C reactive protein （hs-CRP）,pancreatic islet function and insulin resistance of new diagnosed with early onset type 2 diabetes patients.Methods 177 cases of new diagnosed with early onset type 2 diabetes with complete clinical data in our hospital from January 2014 to December 2015 were selected as the research group,the early-onset group （under 40 years old） was 63 cases,the control group （aged 41-59 years old） was 114 cases.The clinical condition including blood lipid,blood pressure,hepatic and renal function,UA,hs-CRP,pancreatic islet function,and insulin resistance in the two groups was compared,and whether there was a higher risk of cardiovascular and cerebrovascular risk in new diagnosed with early onset type 2 diabetes was discussed.Results The level of TC,TG,eGFR,UA,hs-CRP,DBP,HOMA-IR in the early-onset group was higher than that in the control group,and the level of the HDL-C in the early-onset group was lower than that in the control group,with significant difference （P〈0.05）.There was no significant difference in the level of LDL-C,Cr, AUF,AST,SBP,fasting blood glucose,HbAlc,glycosylated albumin and HOMA-IS between the two groups （P〉O.OS）.The age,waist circumference,BMI value in the early-onset group was higher than in the control group,with significant difference （P〈0.05）.Pearson correlation analysis showed that BMI was positively correlated with TG,HOMA-IR and UA,and negatively correlated with age.TG was positively correlated with TC,hs-CRP,HOMA-IR,DBP,UA,BMI,and negatively correlated with HDL-C.Conclusion The clinical conditions about cardiaovascular risk of newly onset diabetes mellitus are more highly.There are the same important to correct the blood lipid disorder,treatment of hyper- uricemia,improvement insulin resistance,antihypertension,as to antihyperglycaemia on new diagnosed with early onset type 2 diabetes to prevent vascular diseases.

关 键 词：早发2型糖尿病 血脂 血压 血尿酸 高敏C反应蛋白 胰岛素抵抗指数 

分 类 号：R587.1[医药卫生—内分泌]