糖尿病前期人群动脉僵硬度及其影响因素调查研究  

Investigation of arterial stiffness and its influencing factors in prediabetic population

作　　者：梁潇 杨勇 王臻 王新 杜京奚 霍超卉 段云友 Liang Xiao;Yang Yong;Wang Zhen;Wang Xin;Du Jingxi;Huo Chaohui;Duan Yunyou(Department of Ultrasound Medicine,Tangdu Hospital of Airforce Military Medical University,Xi′an 710038,China;Department of Endocrinology,Tangdu Hospital of Airforce Military Medical University,Xi′an 710038,China)

机构地区：[1]空军军医大学唐都医院超声医学科,西安710038 [2]空军军医大学唐都医院内分泌科,西安710038

出　　处：《中华超声影像学杂志》2023年第2期117-122,共6页Chinese Journal of Ultrasonography

基　　金：空军军医大学唐都医院临床研究项目(2021LCYJ030)。

摘　　要：目的探究糖尿病前期人群动脉僵硬度水平及其影响因素。方法 2021年6月至2022年6月在唐都医院体检中心及门诊就诊的人群中, 前瞻性随机招募糖尿病前期受检者207例作为糖尿病前期组, 选取同期性别、年龄相匹配的健康志愿者130例作为健康对照组。采用一项超声动脉僵硬度自动测量技术测量受检者颈-股脉搏波传播速度(PWV)、肱-桡PWV、股-踝PWV, 常规评价颈总动脉内中膜厚度(IMT)、左心功能情况, 采集血压、血糖、血脂等临床指标, 并设计问卷调查受检者吸烟、饮酒、饮食、熬夜、运动等生活习惯情况。采用组间比较、多因素线性回归分析相关数据。结果糖尿病前期组颈-股PWV及颈总动脉IMT显著高于健康对照组[(7.10±2.00)m/s对(6.26±1.14)m/s, (0.57±0.11)mm对(0.51±0.08)mm;均P<0.001], 而两组间肱-桡PWV、股-踝PWV测值差异无统计学意义(均P>0.05)。多因素线性回归分析显示, 在调整混杂因素后, 糖尿病前期是颈-股PWV的独立影响因素(P<0.001);此外, 年龄(P<0.001)、舒张压(P<0.001)、熬夜(P=0.011)、低密度脂蛋白胆固醇(P=0.020)亦是颈-股PWV的独立影响因素。结论与健康人群相比, 糖尿病前期人群的主动脉僵硬度显著增加, 而外周动脉的僵硬度则无明显变化。糖尿病前期状态、年龄、舒张压、熬夜、低密度脂蛋白胆固醇是颈-股PWV的独立影响因素。Objective To explore the level of arterial stiffness and its influencing factors in prediabetic population.Methods From June 2021 to June 2022,207 prediabetes patients were prospectively and randomly recruited from the physical examination center and outpatient clinic of Tangdu Hospital of Air Force Military Medical University to be the prediabetic group and 130 healthy volunteers at the same time with the same gender and age as the healthy controls.The carotid-femoral pulse wave velocity(PWV),brachial-radial PWV,and femoral-ankle PWV were measured by an automatic ultrasonic arterial stiffness measurement technology.The common carotid artery wall intima-media thickness(IMT)and left heart function were routinely evaluated.A questionnaire was designed to investigate the subjects′smoking,drinking,diet,staying up late,exercise and other living habits.Comparison between groups and multivariate linear regression analysis were used to analyze the relevant data.Results The carotid-femoral PWV and common carotid artery wall IMT in prediabetic group were significantly higher than those in healthy controls[(7.10±2.00)m/s vs(6.26±1.14)m/s,(0.57±0.11)mm vs(0.51±0.08)mm;both P<0.001],but there were no significant differences in the brachial-radial PWV and femoral-ankle PWV between the two groups(both P>0.05).Multivariate linear regression analysis showed that prediabetes was an independent influencing factor in carotid-femoral PWV after adjusting for confounding factors(P<0.001),in addition,age(P<0.001),diastolic blood pressure(P<0.001),staying up late(P=0.011)and low density lipoprotein cholesterol(P=0.022)were also the independent influencing factors of carotid-femoral PWV.Conclusions Compared with healthy people,the stiffness of aorta is significantly increased in prediabetic people,but there is no significant change in the stiffness of peripheral arteries.Prediabetes,age,diastolic blood pressure,staying up late and low density lipoprotein cholesterol are independent influencing factors of carotid-femoral PWV.

关 键 词：超声多普勒 糖尿病前期 动脉僵硬度 脉搏波传播速度 

分 类 号：R587.1[医药卫生—内分泌]