中老年2型糖尿病患者血清骨钙素水平与颈动脉粥样硬化的关系  

Relationship between serum osteocalcin and carotid atherosclerosis in middle-aged and elderly patients with type 2 diabetes mellitus

作　　者：赵坤 胡静 贺倩倩 王凤翎 张巧娜 范林艳 郭美祥[3] 张珊 杨少玲[2] ZHAO Kun;HU Jing;HE Qianqian;WANG Fengling;ZHANG Qiaona;FAN Linyan;GUO Meixiang;ZHANG Shan;YANG Shaoling(Department of Ultrasound Medicine,Fengxian District Central Hospital Affiliated to Anhui University of Science and Technology,Shanghai 201499,China)

机构地区：[1]安徽理工大学附属奉贤区中心医院超声医学科,上海市201499 [2]上海交通大学附属第六人民医院南院心脏血管超声科 [3]上海交通大学附属第六人民医院南院内分泌科

出　　处：《临床超声医学杂志》2022年第1期21-25,共5页Journal of Clinical Ultrasound in Medicine

基　　金：上海市科学技术委员会引导项目(18411970000);上海市卫生与计划生育委员会课题(201740053)。

摘　　要：目的探讨中老年2型糖尿病(T2DM)患者血清骨钙素(OC)水平与颈动脉粥样硬化(CAS)病变的关系。方法选取我院中老年T2DM患者430例,应用彩色多普勒超声检测双侧颈动脉内-中膜厚度(CIMT),并根据其测值进行分组:CIMT正常(CIMT<1.0 mm)组112例、CIMT增厚(CIMT≥1.0 mm)组106例和CAS斑块组212例。比较各组血清OC水平及其他实验室参数和临床资料的差异;多因素Logistic回归分析OC与CIMT增厚及CAS斑块发生的关系。结果CIMT增厚组平均OC为(11.51±5.02)ng/ml,CAS斑块组平均OC为(11.59±4.23)ng/ml,均低于CIMT正常组(14.16±5.56)ng/ml,差异均有统计学意义(均P<0.01)。CIMT增厚组的年龄、糖尿病病程、高血压病病程均高于CIMT正常组;CAS斑块组的年龄、脉压、吸烟比例、糖尿病病程、高血压病病程、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、糖化白蛋白、糖化血红蛋白、胱抑素C(Cys-C)水平均高于CIMT正常组;CAS斑块组的脉压、吸烟比例、糖尿病病程、LDL-C、hs-CRP和Cys-C水平均高于CIMT增厚组,差异均有统计学意义(均P<0.05)。在调整其他混杂变量后,以OC为连续性变量纳入多因素Logistic回归分析,结果显示OC水平升高是中老年T2DM患者CIMT增厚及CAS斑块的保护因素;以OC 12.24 ng/ml为截断值,多因素Logistic回归分析显示OC<12.24 ng/ml的中老年T2DM患者发生CIMT增厚和CAS斑块的风险较OC≥12.24 ng/ml患者显著增加(P<0.05)。结论OC水平升高是中老年T2DM患者CIMT增厚及CAS斑块发生的保护因素;OC<12.24 ng/ml与CAS发生风险的增加密切相关。Objective To explore the relationship between serum osteocalcin(OC)and carotid atherosclerosis(CAS)in middle-aged and elderly patients with type 2 diabetes mellitus(T2 DM).Methods patients with T2 DM in our hospital were selected,and their carotid intima-media thickness(CIMT)was measured by color Doppler ultrasound,and all the patients were divided into 112 patients in normal CIMT group(CIMT<1.0 mm),106 patients in thickened CIMT group(CIMT≥1.0 mm)and 212 patients in carotid atherosclerotic plaque group according to their measured values.The differences of serum OC levels and other laboratory parameters and clinical data in each group were compared.The relationship between OC and CIMT thickening and the occurrence of CAS plaques was analyzed by multivariate Logistic regression.ResultsThe mean OC of CIMT thickened group and CAS plaque group were(11.51±5.02)ng/ml and(11.59±4.23)ng/ml,both of which were significantly lower than that of CIMT normal group(14.16±5.56)ng/ml(both P<0.01).The age,diabetes course,hypertension course in the CIMT thickened group were higher than those in the CIMT normal group,and the age,the pulse pressure difference,smoking proportion,diabetes course,hypertension course,triglycerides,low-density lipids protein cholesterol(LDL-C),high-sensitivity C-reactive protein(hs-CRP),glycated albumin,glycated hemoglobin and cystatin C(Cys-C)in the CAS plaque group were higher than those in the CIMT normal group,and the pulse pressure difference,smoking proportion,diabetes course,LDL-C,hs-CRP and Cys-C levels in the CAS plaque group were higher than those in the CIMT thickened group,and the differences were statistically significant(all P<0.05).After adjusting for other confounding variables,the results of multivariate Logistic regression analysis with OC as a continuous variable showed that increased OC levels was a protective factor for CIMT thickening and CAS plaques in middle-aged and elderly T2 DM patients.Taking OC was 12.24 ng/ml as the cut-off value,multivariate Logistic regression analysis

关 键 词：超声检查 多普勒 彩色 糖尿病 2型 中老年 骨钙素 颈动脉内膜-中层厚度 粥样硬化斑块 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.1[医药卫生—诊断学]