代谢异常与原发性干燥综合征患者合并2型糖尿病风险的剂量-效应关系  

Dose-Response Relationship Between Metabolic Abnormalities and Risk of Combined Type 2 Diabetes Mellitus in Patients with Primary Sj gren Syndrome

作　　者：李梦依 罗强 张艺文 秦地茂 汪汉 LI Mengyi;LUO Qiang;ZHANG Yiwen;QIN Dimao;WANG Han(Department of Cardiology,The Affiliated Hospital of Southwest Jiaotong University,The Third People’s Hospital of Chengdu,Cardiovascular Disease Research Institute of Chengdu,Chengdu 610031,Sichuan,China)

机构地区：[1]西南交通大学附属医院,成都市第三人民医院心内科,成都市心血管病研究所,四川成都610031

出　　处：《心血管病学进展》2023年第5期476-480,共5页Advances in Cardiovascular Diseases

基　　金：国家临床重点专科建设项目(2021007);国家自然科学基金(81300243);四川省科技厅面上项目(19YYJC0580);四川省中医药管理局课题(2020206)。

摘　　要：目的探讨原发性干燥综合征(pSS)合并2型糖尿病(T2DM)患者的代谢异常情况(血压、血糖、血脂水平),并绘制代谢因素与pSS-T2DM风险之间的剂量-效应关系图。方法本研究为病例对照研究,共纳入2009年1月1日—2020年12月31日在成都市第三人民医院住院就诊的pSS患者,共737例,其中pSS-T2DM患者195例。经过年龄和性别匹配,最终纳入55例pSS-T2DM患者,110例pSS患者,110例健康对照组。结果与不合并T2DM的pSS患者相比,合并T2DM的pSS患者收缩压(SBP)、肌酐、胆固醇、空腹血糖水平较高(P值均<0.05)。多因素logistic回归分析显示:SBP(OR=1.03,95%CI 1.00~1.06,P=0.04)、胆固醇(OR=1.82,95%CI 1.05~3.16,P=0.03)、空腹血糖(OR=2.99,95%CI 1.26~7.08,P=0.01)与T2DM相关。剂量-效应曲线显示SBP与T2DM发病风险之间存在剂量-效应关系(总体关联检验:P=0.01;非线性关联检验:P=0.78;AIC=196.85)。同样,观察到空腹血糖与T2DM发病风险之间存在剂量-效应关系(总体关联检验:P<0.01;非线性关联检验:P=0.10;AIC=97.90)。结论在pSS患者中,SBP、空腹血糖水平与T2DM发生风险呈线性剂量-效应关系,且pSS-T2DM患者比单纯pSS患者更易出现代谢异常。Objective To investigate the metabolic abnormalities(blood pressure,glucose and lipid levels)in patients with primary Sj gren syndrome(pSS)combined with type 2 diabetes mellitus(T2DM)compared with patients with pSS alone and other populations,and to plot the dose-response relationship between metabolic factors and the risk of pSS-T2DM.Methods A total of 737 patients with pSS hospitalized in The Third People’s Hospital of Chengdu from January 1,2009 to December 31,2020 were enrolled in this case-control study,including 195 patients with pSS-T2DM.After matching for age and sex,55 patients with pSS-T2DM,110 patients with pSS,and 110 controls were finally included.Results Compared with pSS patients without combined T2DM,pSS patients with combined T2DM had higher values of systolic blood pressure(SBP),creatinine,cholesterol,and fasting glucose(all P<0.05).Multifactorial logistic regression analysis showed that SBP(OR=1.03,95%CI 1.00~1.06,P=0.04),cholesterol(OR=1.82,95%CI 1.05~3.16,P=0.03),fasting glucose(OR=2.99,95%CI 1.26~7.08,P=0.01)were correlated with T2DM.Dose-response curves showed a linear association between SBP and the risk of developing T2DM(overall association test:P=0.01;non-linear association test:P=0.78;AIC=196.85).Similarly,a linear dose-response association was observed between fasting glucose and the risk of developing T2DM(overall association test:P<0.01;non-linear association test:P=0.10,AIC=97.90).Conclusion There was a linear dose-response relationship between SBP,fasting glucose levels and the risk of developing T2DM in patients with pSS,and patients with pSS-T2DM were more likely to develop metabolic abnormalities than patients with pSS alone.

关 键 词：原发性干燥综合征 糖尿病 收缩压 血糖 

分 类 号：R593.2[医药卫生—内科学] R587.1[医药卫生—临床医学]