2型糖尿病人群血清胆红素水平与动脉硬化及10年心血管病发生风险的关系  

Relationship between serum bilirubin level and arteriosclerosis and 10-year risk of cardiovascular disease in type 2 diabetic population

作　　者：王晓曦 侯慧卿[1] 邵伟华[2] 刘学欣 郭艺芳[2] Wang Xiaoxi;Hou Huiqing;Shao Weihua;Liu Xuexin;Guo Yifang(Department of Physical Examination Center,Hebei General Hospital,Shijiazhuang 050000,China;Department of Geriatrics,Hebei General Hospital,Shijiazhuang 050000,China)

机构地区：[1]河北省人民医院体检中心,石家庄050000 [2]河北省人民医院老年病科,石家庄050000

出　　处：《中国心血管杂志》2023年第3期222-227,共6页Chinese Journal of Cardiovascular Medicine

基　　金：2021年政府资助临床医学人才培养项目(2021046)。

摘　　要：目的探讨2型糖尿病人群不同血清胆红素水平与动脉硬化及10年心血管病(CVD)发生风险的关系。方法回顾性研究。连续纳入2020年1月至2021年12月于河北省人民医院体检中心查体的2型糖尿病患者1169例为观察对象,根据血清胆红素水平进行三分位法分组,比较不同组间的血浆致动脉硬化指数的差异,行颈动脉检查和动脉硬化检测,并应用Framingham风险评分(FRS)计算10年CVD发生风险,FRS<10%为低风险(706例),FRS>10%为高风险(463例)。结果CVD高风险组的血清总胆红素、直接胆红素和间接胆红素水平均低于低风险组(均为P<0.05)。随着血清胆红素水平升高,血浆致动脉硬化指数、臂踝脉搏波速度呈下降趋势;随着血清总胆红素、直接胆红素水平升高,FRS和CVD高风险比例呈下降趋势。多因素logistic回归分析显示,血清总胆红素、直接胆红素和间接胆红素水平均与10年CVD发生高风险呈独立负相关。结论血清胆红素水平较低的2型糖尿病人群,外周动脉硬化及未来10年心血管事件发生风险可能增加。Objective To investigate the association between serum bilirubin level and arteriosclerosis and 10-year risk of cardiovascular disease(CVD)in patients with type 2 diabetes mellitus(DM).Methods This was a retrospective study.A total of 1169 patients with type 2 DM who underwent physical examination in Hebei General Hospital from January 2020 to December 2021 were consecutively enrolled as observation objects.The subjects were divided into three groups according to serum bilirubin level.The plasma arteriosclerosis index(AIP)was compared between different groups,and carotid artery examination and atherosclerosis detection were performed.The Framingham risk score(FRS)was used to calculate the 10-year risk of CVD.FRS<10%was defined as low risk(706 cases),and FRS>10%was defined as high risk(463 cases).Results The serum levels of total bilirubin,direct bilirubin and indirect bilirubin in the high-risk CVD group were lower than those in the low-risk CVD group(all P<0.05).With the increase of serum bilirubin level,AIP and baPWV showed a downward trend.With the increase of serum total bilirubin and direct bilirubin levels,FRS and high-risk proportion decreased.Multivariate logistic regression analysis showed that serum total bilirubin,direct bilirubin and indirect bilirubin levels were independently negatively correlated with a high risk of CVD in 10 years.Conclusions People with type 2 DM who have low serum bilirubin levels may have increased risk of peripheral arteriosclerosis and cardiovascular events in the next 10 years.

关 键 词：2型糖尿病 胆红素 Framingham风险评分 心血管疾病 

分 类 号：R587.2[医药卫生—内分泌] R54[医药卫生—内科学]