2型糖尿病人群心血管危险因素与颈动脉内中膜厚度的关系  

Correlation between cardiovascular risk factors and carotid intima-media thickness in type 2 diabetes mellitus

作　　者：刘彬彬[1] 马宁[1] 贾晓娇[1] 王晓明[1] 王赫楠 王菲 陆强[1] LIU Binbin;MA Ning;JIA Xiaojiao(First Hospital of Qinhuangdao,Hebei,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院,066000

出　　处：《河北医药》2022年第12期1808-1813,共6页Hebei Medical Journal

基　　金：秦皇岛市科学技术研究与发展计划(编号:201902A081)。

摘　　要：目的评估2型糖尿病人群血糖、肥胖等心血管危险因素与颈动脉内中膜厚度(cIMT)的关系,为预防2型糖尿病人群颈动脉硬化提供理论依据。方法纳入2020年11月至2021年3月2型糖尿病人群82例为2型糖尿病组,对照人群171例为对照组,测量收缩压、舒张压、身高、体重,计算BMI;记录吸烟史、饮酒史;测量臀围、腹围、颈围;测定各时点血糖(空腹、0.5 h、1 h、2 h、3 h)、各时点胰岛素(空腹、0.5 h、1 h、2 h、3 h)、糖化血红蛋白、尿酸、TC、TG、HDL-c、LDL-c、内脏脂肪面积、cIMT,记录有无斑块。分别比较2型糖尿病组与对照组、2型糖尿病组中腹型肥胖与非肥胖组、cIMT增厚与非增厚组上述指标的差异;行Pearson相关及多元线性回归分析各时点血糖及不同肥胖指标与cIMT的关系。结果2型糖尿病组体重、BMI、臀围、腹围、颈围、血糖(空腹、0.5 h、1 h、2 h、3 h)、胰岛素(空腹、0.5 h、2 h、3 h)、糖化血红蛋白、尿酸、TC、TG、LDL-c、内脏脂肪面积、cIMT均高于对照组,HDL-C低于对照组(P<0.05)。与非肥胖组人群比较,2型糖尿病肥胖组的收缩压、舒张压、体重、BMI、臀围、腹围、颈围、1 h血糖、胰岛素(空腹、1 h、3 h)、尿酸、TG、内脏脂肪面积、cIMT均增高,HDL-c减低(P<0.05)。与cIMT非增厚组比较,2型糖尿病cIMT增厚组收缩压、体重、血糖(1 h、3 h)、胰岛素(空腹、1 h)、糖化血红蛋白、尿酸、有无斑块比例均增高(P<0.05)。单因素相关分析结果显示,2型糖尿病组中体重、BMI、臀围、腹围、颈围、内脏脂肪面积、各时点血糖均与cIMT呈正相关(P<0.001),但各时点胰岛素水平与cIMT无关。回归分析显示,与其他肥胖指标及其他时点血糖比较,内脏脂肪面积和1 h血糖对cIMT的影响更大。结论纳2型糖尿病组更应关注1 h血糖及内脏脂肪面积对cIMT的影响,以更有效的预防颈动脉内膜增厚。Objective To evaluate the correlation between cardiovascular risk factors and carotid intima-media thickness(cIMT)in type2 diabetes mellitus(T2DM)by comparing blood glucose(BG),obesity and other indexes,aiming to provide theoretical for prevention of carotid atherosclerosis(CAS).Methods From November 2020 to March 2021,totally 82 T2DM and 171 controls were enrolled in the T2DM group and the control group.The baseline indexes(systolic blood pressure SBP,diastolic blood pressure DBP,height,weight,body mass index BMI,smoking history,drinking history,hip circumference HC,abdominal circumference AC,neck circumference NC)were included as comparatorscomparison.The key observation was BG levels(fasting,0.5h,1h,2h,3h)and insulin indexes(fasting,0.5h,1h,2h,3h),glycosylated hemoglobin(GHb),uric acid(UA),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),visceral fat area(VFA),cIMT,the presence of plaques between the T2DM group and the control group.In the T2DM group,the above differences were also compared from abdominal obesity subgroup vs non-obese subgroup,and from the cIMT thickening subgroup and vs no-cIMT thickening subgroup;Pearson correlation and multiple linear regression analysis were performed to assess the correlation between different BG levels,obesity indexes and cIMT.Results Weight,BMI,HC,AC,NC,BG levels(fasting,0.5h,1h,2h,3h),insulin indexes(fasting,0.5h,2h,3h),GHb,UA,TC,TG,LDL-c,VFA,cIMT were increased in the T2DM group but not in the control group,while HDL-c was decreased in the T2DM group(P<0.05).Increased SBP,DBP,weight,BMI,HC,AC,NC,one-hour plasma glucose(1hPG),insulin indexes(fasting,1h,3h),UA,TG,VFA,cIMT,and decreased HDL-c in the abdominal obesity subgroup were detected than those in the non-obese subgroup(P<0.05).SBP,weight,BG levels(1h,3h),insulin indexes(fasting,1h),GHb,UA,the presence of plaques were increased in the cIMT thickening subgroup relevant to the no-cIMT thickening subgroup(P<0.05).The simple correlation analys

关 键 词：2型糖尿病 心血管危险因素 颈动脉内中膜厚度 不同时点血糖 内脏脂肪面积 

分 类 号：R587.1[医药卫生—内分泌]