2型糖尿病患者残余胆固醇水平对颈动脉内膜厚度的影响  

Effect of remnant cholesterol levels on carotid intima thickness in patients with type 2 diabetes mellitus evaluated by ultra-high frequency ultrasound

作　　者：马一鸣 袁建军[2] 张梅[3] 郭艳艳 徐瑞[2] 张岩岩 张涵[2] 张喜君[2] 朱好辉[2] Ma Yiming;Yuan Jianjun;Zhang Mei;Guo Yanyan;Xu Rui;Zhang Yanyan;Zhang Han;Zhang Xijun;Zhu Haohui(Xinxiang Medical University,Xinxiang 453000;Department of Ultrasound,Henan Provincial People′s Hospital,Zhengzhou 450003,China;Department of Cardiology,Qilu Hospital of Shandong University,Jinan 250000,China)

机构地区：[1]新乡医学院,新乡453000 [2]河南省人民医院超声科,郑州450003 [3]山东大学齐鲁医院心内科,济南250000

出　　处：《中华超声影像学杂志》2023年第6期508-514,共7页Chinese Journal of Ultrasonography

基　　金：国家重点研发计划(2022YFC3602400);河南省科技攻关项目(222102310053);2021年度河南省卫生健康中青年学科带头人培育项目;河南省医学适宜技术推广项目(SYJS2022019)。

摘　　要：目的探讨2型糖尿病(T2DM)患者残余胆固醇(RC)水平对颈动脉内膜厚度(CIT)的影响。方法前瞻性连续纳入2021年5月至2022年7月在河南省人民医院就诊的T2DM患者60例,根据RC的中位水平分为RC较高组(31例)和RC较低组(29例)。选取同期性别、年龄、体质指数(BMI)相匹配的健康志愿者31例作为对照组。使用24 MHz超高频超声探头测量研究对象CIT、中膜厚度(CMT)和内中膜厚度(CIMT)。比较三组间的一般临床资料、实验室指标及CIMT、CIT、CMT的差异,通过多因素回归分析探讨T2DM患者CIT的影响因素。结果①三组间性别、年龄、BMI、高密度脂蛋白胆固醇(HDL-C)及CMT比较差异无统计学意义(均P>0.05);T2DM两亚组间糖尿病病程、空腹血糖及糖化血红蛋白比较差异无统计学意义(均P>0.05)。②与对照组相比,T2DM组CIMT及CIT增厚(均P<0.05)。③T2DM两亚组间比较,RC较高组CIT较RC较低组增厚(P<0.05),而两组间CIMT比较差异无统计学意义(P>0.05)。④多因素线性回归分析显示,T2DM患者中RC仍是CIT的影响因素(β=0.610,P=0.005)。结论RC较高的T2DM患者CIT比RC较低的患者增厚,且RC是CIT的影响因素,提示临床进行干预时应更加关注T2DM患者RC的检测。Objective To discuss the effect of remnant cholesterol(RC)levels on carotid intima thickness(CIT)in patients with type 2 diabetes mellitus(T2DM)by ultra-high frequency ultrasound.Methods A total of 60 patients with T2DM who received treatment in Henan Provincial People′s Hospital from May 2021 to July 2022 were prospectively recruited,and they were divided into a higher RC group(31 cases)and a lower RC group(29 cases)according to the RC levels.Thirty-one age,sex and body mass index(BMI)-matched healthy volunteers were selected as control group.Carotid CIT,carotid media thickness(CMT)and intima-media thickness(CIMT)were measured by 24 MHz ultra-high frequency ultrasound probe.The difference of general clinical data,laboratory indicators and CIMT,CIT,CMT among the three groups were compared,and the influencing factors of CIT in T2DM patients were explored by multivariate regression analysis.Results①There were no statistical significances in gender,age,BMI,high-density lipoprotein cholesterol(HDL-C)and CMT among the three groups(all P>0.05).There were no statistical significances in duration of diabetes,fasting blood-glucose and glycated haemoglobin between the two subgroups of T2DM(all P>0.05).②Compared with the control group,CIMT and CIT were thicker in the T2DM group(both P<0.05).③CIT was thicker in the higher RC group than in the lower RC group(P<0.05),while the difference of CIMT was not statistically significant the two groups(P>0.05).④Multivariate regression analysis showed that RC was the influence factor of CIT in patients with T2DM(β=0.610,P=0.005).Conclusions CIT is significantly thicker in T2DM patients with higher RC than in those with lower RC,and RC is the influence factor of CIT,which suggests that more attention should be paid to the detection of RC in T2DM patients.

关 键 词：超高频超声 2型糖尿病 残余胆固醇 颈动脉内膜厚度 

分 类 号：R587.1[医药卫生—内分泌]