围绝经期2型糖尿病患者雌激素与心血管危险因素的相关性研究  

Association between estrogen level and the risk of cardiovascular disease in perimenopausal type 2 diabetic patients

作　　者：胡家[1] 倪林[1] 霍丽霞 张玲[1] HU Jia;NI Lin;HUO Lixia(Department of Endocrinology,the First People’s Hospital of Huzhou,Huzhou 313000,China)

机构地区：[1]湖州市第一人民医院内分泌科,313000 [2]湖州市第一人民医院中心实验室,313000

出　　处：《浙江医学》2020年第9期913-916,共4页Zhejiang Medical Journal

基　　金：浙江省科技计划项目(2020KY310);湖州市科技计划项目(2017GYB15)。

摘　　要：目的探讨围绝经期2型糖尿病(T2DM)患者雌激素与心血管危险因素的相关性。方法选取277例围绝经期T2DM患者,根据绝经期分为绝经前期121例(对照组)和绝经后期156例(病例组),收集两组患者的一般资料、空腹血糖(FPG)、血脂、体重指数(BMI)、血压、糖化血红蛋白(HbA1C)、甲状腺功能、雌激素(E2)、颈动脉内膜中层厚度等。对E2与心血管疾病各个危险因素腰围、FPG、HbA1C、总胆固醇(TC)等进行相关性分析。结果 (1)两组糖尿病病程、腰围、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL)等基线数据相比,差异均无统计学意义(均P>0.05)。病例组年龄、BMI、FPG、HbA1C、SBP、TC、颈动脉内膜中层厚度均高于对照组,血清E2水平低于对照组,差异均有统计学意义(均P<0.05)。(2)E2水平与腰围、FPG、Hb A1C、TC之间呈负相关,与LDL呈正相关。多元线性回归分析提示FPG、TC、腰围为血清E2的独立影响因素。结论 T2DM女性患者绝经后多种心血管危险因素如FPG、TC、腰围等水平升高,具备更高的心血管疾病发病风险,并可能通过E2水平的降低而增加发生心血管疾病的风险。Objective To assess the relationship between estrogen level and risk of cardiovascular diseases in perimenopausal patients with type 2 diabetes mellitus(T2DM).Methods A total of 277 T2DM patients admitted from January 2016 to January 2019 were enrolled in the study,including 121 postmenopausal cases(study group)and 158 premenopausal cases(control group).The levels of plasma fasting glucose(FPG),serum lipids,body mass index(BMI),glycated hemoglobin(HbA1C)and estrogen(E2),the thyroid function,carotid intima-media thickness were compared between two groups.The relationship of E2 with waist/hip ratio(WHR),FPG,HbA1C,total cholesterol(TC)were analyzed.Results There was no significant difference in duration of diabetes,WHR,and levels of free triiodothyronine(FT3),free thyroxine(FT4),triglyceride(TG),low density lipoprotein(LDL)between the two groups(P>0.05).In the case group,the age,BMI,HbA1C,FPG,TC,carotid intima-media thickness were significantly higher than those in the control group,the lever of E2 was lower than that in the control group(P<0.05).The E2 level were negatively correlated with WHR,FPG,HbA1C,TC and positively correlated with LDL(all P<0.05).Multiple stepwise regression analysis showed that FPG,TC and WHR were independently associated with E2.Conclusion Postmenopausal women with diabetes may have one or more cardiovascular risk factors(FPG,TC,WHR),and an increased risk of cardiovascular disease,which is associated with the decreased estrogen level.

关 键 词：2型糖尿病 围绝经期 雌激素 心血管疾病 

分 类 号：R587.1[医药卫生—内分泌]