高血压合并2型糖尿病患者颈动脉内-中膜增厚的影响因素和甘油三酯-葡萄糖指数评估颈动脉内-中膜增厚的价值研究  

Research on the influencing factors of carotid intima-media thickening and the predictive value of the triglyceride-glucose index for carotid intima-media thickening in patients with hypertension and type 2 diabetes mellitus

作　　者：黄媞 戴霞[1] 张莉莉 徐丹青 黎学颖 HUANG Ti;DAI Xia;ZHANG Lili;XU Danqing;LI Xueying(The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China)

机构地区：[1]广西医科大学第一附属医院,南宁市530021

出　　处：《内科》2023年第1期14-17,32,共5页Internal Medicine

基　　金：广西科技厅重点研发课题(桂科AB20297008)。

摘　　要：目的 分析高血压合并2型糖尿病(T2DM)患者颈动脉内-中膜厚度(CIMT)增厚的影响因素,并探讨甘油三酯-葡萄糖(TyG)指数评估CIMT增厚的价值。方法 选取209例高血压合并T2DM患者作为研究对象,收集患者的一般临床资料,以及实验室检查和颈动脉彩色多普勒超声检查结果。依据有无CIMT增厚将患者分为CIMT增厚组(n=111)、CIMT未增厚组(n=98)。对比两组患者临床资料,并对其中影响CIMT增厚的因素应用二分类多因素logistic回归进行分析,绘制TyG指数评估CIMT增厚的受试者操作特征(ROC)曲线。结果 两组患者性别、年龄、T2DM病程、高密度脂蛋白-胆固醇(HDL-C)水平、空腹血糖水平、糖化血红蛋白、TyG指数的差异均有统计学意义(均P<0.05)。男性、年龄增大、TyG指数较高均是高血压合并T2DM患者CIMT增厚的危险因素,HDL-C水平升高是其CIMT增厚的保护因素(均P<0.05)。TyG指数评估CIMT增厚的ROC曲线下面积为0.606,最佳截断值为7.7(灵敏度为39.81%,特异度为83.16%,Youden指数为0.230)。结论 男性、年龄增加、TyG指数增大均是高血压合并T2DM患者CIMT增厚的危险因素,HDL-C水平升高是其CIMT增厚的保护因素。TyG指数在评估高血压合并T2DM患者CIMT增厚方面有一定的价值。Objective To analyze the influencing factors of carotid intima-media thickness(CIMT)thickening in patients with hypertension and type 2 diabetes mellitus(T2DM),and to explore the value of triglyceride-glucose(TyG)index in evaluating CIMT thickening.Methods A total of 209 patients with hypertension and T2DM were selected as research subjects,and their general clinical data and results of laboratory tests and carotid artery color Doppler ultrasound tests were collected.According to whether they had CIMT thickening or not,the patients were divided into a CIMT thickening group(n=111)or a CIMT non-thickening group(n=98).The clinical data of the two groups were compared,among which the factors affecting CIMT thickening were analyzed by binary classification multivariate logistic regression,and the receiver operating characteristic(ROC)curve of the TyG index in evaluating CIMT thickening was drawn.Results There were statistically significant differences in gender,age,T2DM course,high-density lipoprotein-cholesterol(HDL-C)level,fasting blood glucose level,hemoglobin A1c,and TyG index between the two groups(all P<0.05).Male,aging,and high TyG index were risk factors for CIMT thickening in patients with hypertension and T2DM,and an elevated HDL-C level was a protective factor for their CIMT thickening(all P<0.05).The area under the ROC curve of the TyG index in evaluating CIMT thickening was 0.606 and the optimal cut-off value was 7.7(the sensitivity was 39.81%,the specificity was 83.16%,and the Youden index was 0.230).Conclusion Male,aging,and high TyG index are risk factors,and an elevated HDL-C level is a protective factor for CIMT thickening in patients with hypertension and T2DM.The TyG index has a certain value in evaluating CIMT thickening in patients with hypertension and T2DM.

关 键 词：高血压 2型糖尿病 颈动脉内-中膜 甘油三酯-葡萄糖指数 高密度脂蛋白-胆固醇 

分 类 号：R543.4[医药卫生—心血管疾病]