新诊断2型糖尿病患者β细胞第一时相分泌功能与颈部动脉粥样硬化斑块的相关性研究  

Correlation BetweenβCell First-phase Secretion Function and Cervical Atherosclerotic Plaque in Newly Diagnosed Type 2 Diabetes Mellitus

作　　者：桑丹 臧嘉斌 庄雄杰 曾玲 段新月 柳岚 SANG Dan;ZANG Jiabin;ZHUANG Xiongjie;ZENG Ling;DUAN Xinyue;LIU Lan(Department of Endocrinology,The Eighth Affiliated Hospital,Sun Yat-sen University,Shenzhen(518033),Guangdong,China)

机构地区：[1]中山大学附属第八医院(深圳福田)内分泌科,广东省深圳市518033 [2]中山大学附属第八医院(深圳福田)心血管内科,广东省深圳市518033

出　　处：《中国循环杂志》2022年第2期148-153,共6页Chinese Circulation Journal

基　　金：深圳市福田区卫生和计划生育局卫生公益性科研项目(FTWS2018091);深圳市卫生计生系统科研项目(SZSJ2017003)。

摘　　要：目的:探讨新诊断2型糖尿病(T2DM)患者β细胞第一时相分泌功能与颈部动脉粥样硬化斑块的关系。方法:选取2018年1月至2021年1月就诊于我科的新诊断T2DM患者328例,其中男性237例,女性91例,平均年龄(49.1±13.4)岁。根据精氨酸刺激试验(AST)后C肽(CP)变化[CP增值(ΔCP)],将研究对象分为低ΔCP组(n=110)、中ΔCP组(n=109)、高ΔCP组(n=109)。收集各组患者临床资料及生化指标,行彩色多普勒超声检测患者双侧颈动脉及锁骨下动脉。结果:随着空腹CP及ΔCP的降低,颈部动脉粥样硬化斑块的患病率逐渐升高,在高ΔCP组、中ΔCP组和低ΔCP组分别为43.1%、56.9%、68.2%(P<0.05);在校正其他混杂因素后进行多因素Logistic回归分析,结果显示,ΔCP下降与颈部动脉粥样硬化斑块的发生独立相关(β值=-0.332,OR=0.717,95%CI:0.571~0.902,P<0.05);与高ΔCP组比较,中ΔCP组、低ΔCP组罹患颈部动脉粥样硬化斑块的OR值(95%CI)分别为1.967(0.969~3.995)和2.681(1.256~5.721)。结论:新诊断T2DM患者β细胞第一时相分泌功能下降与颈部动脉粥样硬化斑块发生密切相关。Objectives:To investigate the relationship betweenβcell first-phase secretion function and cervical atherosclerotic plaques in newly diagnosed type 2 diabetes mellitus(T2DM)patients.Methods:A total of 328 newly diagnosed T2DM patients admitted to our department from January 2018 to January 2021 were included and patients were divided into low,medium and high ΔCP groups according to the C-Peptide change(CP increment,ΔCP)after arginine stimulation test(AST).Clinical data and biochemical indexes of each group were compared,and color Doppler ultrasound was used to detect atherosclerotic plaques in carotid artery and subclavian artery.Results:With the decrease of fasting CP and ΔCP,the incidence of cervical atherosclerosis increased gradually,which were 43.1%,56.9%and 68.2%in high ΔCP group,middle ΔCP group and low ΔCP group,respectively(P<0.05).After adjusting for other confounders,multivariate logistic regression analysis showed that the decrease of ΔCP(β=-0.332,OR=0.717,95%CI:0.571-0.902,P<0.05)was independently associated with the occurrence of cervical atherosclerotic plaques.The OR values(95%CI)of middle and low ΔCP group for cervical atherosclerotic plaques were 1.967(0.969-3.995)and 2.681(1.256-5.721)respectively,compared with those of high ΔCP group.Conclusions:The decrease ofβcell first-phase secretion function is closely related to the occurrence of cervical atherosclerotic plaque in newly diagnosed T2DM patients.

关 键 词：新诊断 2型糖尿病 Β细胞 第一时相 颈部动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病]