山西省长治市社区老年2型糖尿病患者血清白脂素对颈动脉粥样硬化的风险评估  

Association between serum asprosin and carotid atherosclerosis in elderly patients with type 2 diabetes in Changzhi,Shanxi

作　　者：尹建红[1] 刘鸣[1] 孙莉 徐民岗 史国良 梁栋[1] 武倩倩 苏鸿 许淑婷 秦娜 许林鑫[1] Yin Jianhong;Liu Ming;Sun Li;Xu Mingang;Shi Guoliang;Liang Dong;Wu Qianqian;Su Hong;Xu Shuting;Qin Na;Xu Linxin(Department of Endocrinology,First Affiliated Hospital,Shanxi Medical University,Taiyuan 030001,China;Department of Endocrinology,Changzhi Second People′s Hospital in Shanxi Province,Changzhi 046000,China;International College of Nursing,Hainan Medical College,Hainan 570100,China)

机构地区：[1]山西医科大学第一医院内分泌科,太原030001 [2]山西省长治市第二人民医院内分泌科,长治046000 [3]海南医学院国际护理学院,海南570100

出　　处：《中华糖尿病杂志》2022年第3期253-259,共7页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：中华国际医学交流基金会中华糖尿病科研基金(Z-2017-26-1902-3)。

摘　　要：目的探讨社区老年2型糖尿病(T2DM)患者血清白脂素水平与颈动脉粥样硬化的关系。方法选取2019年11月至2021年7月就诊于山西省长治市捉马社区卫生服务站和城北西街社区卫生服务中心的65岁及以上的老年T2DM患者。收集患者身高、体重、并计算体重指数(BMI),收集患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、血清白脂素等资料,超声测量颈动脉内中膜厚度(CIMT)。根据曼海姆共识,将CIMT≥1.5 mm和(或)颈动脉有斑块的患者纳入有颈动脉粥样硬化组,其余纳入无颈动脉粥样硬化组。采用t检验、Mann WhitneyU检验或χ2检验对两组间各指标进行比较,采用Pearson或Spearman相关分析法评价血清白脂素与其他临床资料的相关性,采用多元逐步logistic回归分析法分析颈动脉粥样硬化和颈动脉内中膜增厚的影响因素。结果共纳入385例老年T2DM患者,无颈动脉粥样硬化组137例,有颈动脉粥样硬化组248例。与无颈动脉粥样硬化组患者相比,有颈动脉粥样硬化组患者血清白脂素更高(P<0.001),BMI、FPG、TG和HbA1c均更低(P<0.05)。Pearson相关分析显示,T2DM患者血清白脂素与左、右两侧CIMT均呈正相关(r值分别为0.306和0.324,P<0.001)。多元逐步logistic回归分析结果显示,血清白脂素是颈动脉粥样硬化的影响因素[OR值(95%CI)为1.021(1.015~1.027),P<0.001],与白脂素<279.6 pg/ml的患者相比,白脂素介于279.6~344.0 pg/ml之间[OR值(95%CI)为7.381(3.495~15.587),P<0.001]及白脂素>344 pg/ml[OR值(95%CI)为30.157(9.272~98.088),P<0.001]的患者发生颈动脉粥样硬化的风险更高。结论山西省长治市社区老年T2DM患者血清白脂素与CIMT呈正相关,是颈动脉粥样硬化的影响因素,且随着白脂素的升高,患者发生颈动脉粥样硬化的风险增高。Objective To assess the association of serum asprosin with carotid atherosclerosis among elderly individuals with type 2 diabetes mellitus(T2DM)in the community.Methods Elderly T2DM patients aged 65 and over who were treated at the Zhuoma Community Health Service Station and Chengbei West Street Community Health Service Center in Changzhi City,Shanxi Province from November 2019 to July 2021 were enrolled.The patients′height and weight were collected,then the body mass index(BMI)were calculated.The data of patient′s fasting plasma glucose(FPG),glycated hemoglobin A1c(HbA1c),triglyceride(TG)and serum albumin were also collected.The carotid intima media thickness(CIMT)were measured by ultrasonography.According to the Mannheim Consensus,patients whose CIMT≥1.5 mm and/or carotid artery plaque were included in the carotid atherosclerosis group,and the rest were included in the carotid atherosclerosis group.Comparisons of continuous variables between two groups were made using Student′s t-test,MannWhitney U test orχ2 test.Pearson′s or Spearman′s correlation analysis was used to analyze the association between serum asprosin and other clinical data.Multivariate stepwise logistic regression analysis was used to analyze the influencing factors of carotid atherosclerosis and carotid intima media thickening.Results A total of 385 elderly patients with T2DM were enrolled.There were 137 cases in the non carotid atherosclerosis group and 248 cases in the carotid atherosclerosis group.Compared with patients without carotid atherosclerosis group,patients with carotid atherosclerosis group had higher serum aspoin(P<0.001),and lower BMI,FPG,TG and HbA1c(P<0.05).Pearson′s correlation analysis showed that serum asprosin in patients with T2DM was positively correlated with CIMT on the left and right sides(r values were 0.306 and 0.324,respectively,P<0.001).Multivariate stepwise logistic regression analysis showed that serum asprosin was an influencing factor of carotid atherosclerosis[OR(95%CI)1.021(1.015-1.027),P<0.001

关 键 词：糖尿病 2型 颈动脉疾病 白脂素 风险评估 

分 类 号：R587.1[医药卫生—内分泌]