老年2型糖尿病患者血糖控制水平与颈动脉斑块及脉搏波速度的相关性研究  

Association of blood glucose control with carotid plaque and pulse wave velocity in elderly patients with type 2 diabetes mellitus

作　　者：冯艳艳[1] 于飞[1] 毕源杰 徐梅[1] 付春莉[1] 于昕[1] 蔡茜[1] 高海青[1] 程梅[1] Feng Yanyan;Yu Fei;Bi Yuanjie;Xu Mei;Fu Chunli;Yu Xin;Cai Qian;Gao Haiqing;Cheng Mei(Geriatrics Department, Qilu Hospital of Shandong University, Ji＇nan 250012, China)

机构地区：[1]山东大学齐鲁医院老年病科,济南250012

出　　处：《中华老年医学杂志》2018年第7期755-759,共5页Chinese Journal of Geriatrics

基　　金：山东省自然科学基金青年基金项目(ZR2015HQ025)

摘　　要：目的探讨老年2型糖尿病患者糖化血红蛋白（HbA1C）水平与颈动脉斑块和脉搏波速度（PWV）的相关性及其影响因素。方法横断面研究，老年2型糖尿病患者130例，年龄60～92岁，其中男性59例。根据HbA1C水平分为3组：HbA1CG7．0％49例、7．0％≤HbA1CG8．5％58例、HbA1c≥8．5％23例。测定身高、体质量、血压、血糖、血脂、HbA1C等指标，进行颈动脉超声和PWV检查。结果3组比较，收缩压、空腹血糖、高密度脂蛋白胆固醇、颈动脉内中膜厚度（IMT）、斑块积分、斑块稳定性、PWV差异有统计学意义（均P〈0．05）。颈动脉IMT与性别、年龄、空腹血糖、HbA1C、高密度脂蛋白胆固醇相关（r值分别为0．389、0．296、0．203、0．405、-0．208，均P〈0．05）；颈动脉斑块积分与性别、年龄、HbA1C和高密度脂蛋白胆固醇相关（r值分别为0．321、0．355、0．340、-0．249，均P〈0．01）；颈动脉斑块稳定性与体质指数、收缩压、HbA1C和高密度脂蛋白胆固醇相关（r值分别为-0．286、-0．188、-0．368、0．405，均P〈0．05）；PWV与年龄、收缩压、舒张压、空腹血糖、HbA1C、三酰甘油、总胆固醇、低密度脂蛋白胆固醇相关（r值分别为0．516、0．521、0．225、0．181、0．229、-0．253、-0．311、-O．244，均P〈0．05）。颈动脉IMT与PWV呈正相关（r=0．234，P〈0．01）。Logistic回归分析结果显示，性别、年龄和HbA1C与IMT独立相关；性别、年龄、体质指数和HbA1C与颈动脉粥样硬化斑块积分大小独立相关；年龄、HbAm高密度脂蛋白胆固醇与粥样斑块稳定性独立相关；年龄和收缩压与PWV独立相关。结论HbA1C、收缩压、高密度脂蛋白胆固醇、体质指数是老年糖尿病患者发生动脉硬化的独立危险因素。Objective To investigate the correlation of glycosylated hemoglobin（HbA1C）levels with carotid atherosclerotic plaque and pulse wave velocity （PWV） in elderly patients with type 2 diabetes mellitus （T2DM）： Methods There were 130 cases of elderly patients with T2DM, aged from 60 to 92 years,of whom there were 59 males. All subjects were divided into 3 groups based on the HbAlclevels：the low level group （HbA1C〈7% ,n=49）,the middle level group （7%HbA1C〈8.5% , n = 58） and the high level group （ HbA1C〈8.5%, n=23）. Height, body weight, blood pressure, blood glucose, blood lipids, HbAlc and other indexes were collected and compared among groups. In addition,carotid ultrasound and PWV examinations were performed. Results There were significant difference in levels of systolic blood pressure （SBP）, fasting blood glucose （FBG）, high density lipoprotein cholesterol （HDL-C）, carotid intima-media thickness （IMT）, plaque score, plaque stability and PWV among groups （all P〈0.05）. Correlation analysis showed that IMT levels were correlated with gender （r=0.389）,age （r=0.296）,FBG （r=0.203）,HbA1c（r=0.405） and HDL-C （r= --0.208）,all P〈0.05. Carotid artery plaque score correlated with gender （r =0.321）,age （r= 0.355）,HbA1c（r=0.340） and HDL-C （r=-0.249） （all Pd0.01）and there is a correlation between the stability of carotid plaques with body mass index （BMI） （r = - 0. 286）, SBP （r =-0. 188）,HbA1C（r=-0. 368） and HDL--C （r=0. 405） （all P〈0.05）;PWV was correlated with age （r=0. 516）,SBP （r=0. 521）,diastolic blood pressure （r=0. 225）,FBG （r=0. 181）,HbAlc （r =0. 229）,triglyceride （r=--0. 253） ,total cholesterol （r=-0. 311） and LDL-C （r=-0. 244） ,all P〈 0.05.Moreover, there was a correlation between IMT and PWV （ r = 0. 234, P 〈 0.01 ）. Logistic regression analysis showed that gender, age and HbA1c were independently associated with IMT; gender,age,BMI and HbA1c were independentl

关 键 词：糖尿病 2型 颈动脉狭窄 血管中膜 

分 类 号：R587.1[医药卫生—内分泌]