125例老年2型糖尿病患者慢性血管并发症的危险因素分析  被引量:11

Analysis of risk factors for chronic vascular complications in 125 elderly patients with type 2 diabetes mellitus

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作  者:张子月 王璋 钟大鹏 ZHANG Ziyue;WANG Zhang;ZHONG Dapeng(Cadre Ward and Endocrinology Department,General Hospital of the Western Theater Command of the Chinese People's Liberation Army,Chengdu 610081,Sichuan,China;Department of Endocrinology,General Hospital of the Western Theater Command of the Chinese People's Liberation Army,Chengdu 610081,Sichuan,China)

机构地区:[1]中国人民解放军西部战区总医院干部病房,四川成都610081 [2]中国人民解放军西部战区总医院内分泌科,四川成都610081

出  处:《贵州医科大学学报》2023年第2期177-181,187,共6页Journal of Guizhou Medical University

基  金:四川省干部保健科研课题(18BJZ16)。

摘  要:目的分析老年2型糖尿病(T2DM)患者慢性血管并发症的危险因素。方法选择60岁以上老年T2DM患者125例,按照是否合并慢性血管并发症分为合并组(n=57)和未合并组(n=68),比较两组患者一般资料[性别、年龄、糖尿病病程、体质量指数(BMI)、血压]、血糖相关指标[空腹血糖(FBG)、糖化血红蛋白(HbAlc)、平均血糖值(MAGE)、血糖标准差(SD-BG)]和生化指标[总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、血尿酸(SUA)、甘油三酯(TG)、血肌酐(Scr)、血尿素氮(BUN)];采用多因素logistic回归分析老年T2DM患者慢性血管并发症的危险因素,分析血糖波动对预测老年T2DM慢性血管并发症的价值。结果两组患者在性别、烟酒史和血压情况、FBG、TC、HDL-C、LDL-C等方面比较,差异无统计学意义(P>0.05);合并慢性血管并发症组患者年龄大于未合并组,T2DM病程长于未合并组,差异有统计学意义(P<0.05);合并组MAGE、SD-BG和HbAlc、SUA、TG、Scr、BUN均高于未合并组,差异有统计学意义(P<0.05);多因素logistic回归分析显示,病程长、MAGE、SD-BG、TG、Scr和BUN水平升高是老年T2DM患者发生慢性血管并发症的危险因素(P<0.05);受试者工作特征曲线(ROC)结果示,MAGE和SD-BG联合预测老年T2DM是否合并慢性血管并发症的效能较高,其曲线下面积(AUC)为0.853,约登指数为0.634,敏感度、特异性分别为73.68%、89.71%。结论血糖波动幅度大、血糖控制不佳且病程长是导致老年T2DM患者发生慢性血管并发症的危险因素。Objective To analyze the risk factors of chronic vascular complications in elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 125 elderly T2DM patients over 60 years of age were selected and divided into combined group(n=57)and uncombined group(n=68)according to whether they had chronic vascular complications.The general data[gender,age,diabetes duration,body mass index(BMI),blood pressure)],blood glucose related indicators[fasting blood glucose(FBG),glycated hemoglobin(HbAlc),mean blood glucose value(MAGE),blood glucose standard deviation(SD-BG)],and biochemical indexes[total cholesterol(TC),high-density lipoprotein(HDL-C),low density lipoprotein(LDL-C),blood uric acid(SUA),triglycerides(TG),blood creatinine(Skr),blood urea nitrogen(BUN)]were compared between two groups.Multivariate logistic regression was used to analyze the risk factors of chronic vascular complications in elderly T2DM patients and to analyze the value of blood glucose fluctuations for predicting chronic vascular complications in elderly T2DM.Results There were no significant differences between the two groups regarding gender,tobacco,and alcohol history,and blood pressure,FBG,TC,HDL-C,and LDL-C(P>0.05).Patients in the group with chronic vascular complications were older than the uncombined group,and the duration of T2DM was longer than the uncombined group.The difference was statistically significant(P<0.05).The combined groups with MAGE,SD-BG,and HbAlc,SUA,TG,Scr,and BUN were all higher than those in the uncombined group,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that long disease duration,MAGE,SD-BG,TG,Scr,and elevated levels of BUN were risk factors for chronic vascular complications in elderly patients with T2DM(P<0.05).The receiver operating characteristic curve(ROC)results showed that MAGE and SD-BG were more effective in predicting whether T2DM occurs with chronic vascular complications in the elderly.The area under the curve(AUC)was 0.853,the Youden in

关 键 词:老年2型糖尿病 血糖波动幅度 慢性血管并发症 危险因素 

分 类 号:R587.1[医药卫生—内分泌]

 

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