残粒脂蛋白胆固醇与2型糖尿病患者颈动脉斑块的关系研究  

Relationship between remnant lipoprotein cholesterol and carotid plaque in patients with type 2 diabetes mellitus

作　　者：王国安[1] 龚莉 陈雪品 管军[2] Wang Guoan;Gong Li;Chen Xuepin;Guan Jun(Qingdao Hospital of Rehabilitation University,Qingdao Municipal Hospital,Shandong Qingdao 260000,China;Department of Cardiology,Qingdao Hospital of Rehabilitation University,Qingdao Municipal Hospital,Shandong Qingdao 260000,China)

机构地区：[1]康复大学青岛医院,青岛市市立医院医院办公室,山东青岛260000 [2]康复大学青岛医院,青岛市市立医院心内科,山东青岛260000

出　　处：《中国医刊》2023年第11期1180-1183,共4页Chinese Journal of Medicine

基　　金：青岛市医疗卫生优秀学科带头人计划(青卫政字[2022]6号);青岛市市南区科技计划项目(2022-2-011-YY)。

摘　　要：目的探讨血浆残粒脂蛋白胆固醇(remnant lipoprotein cholesterol,RLP-C)水平与2型糖尿病(type 2 diabetes mellitus,T2DM)患者颈动脉斑块的关系。方法回顾性分析青岛市市立医院内分泌科2021年6月至2022年3月收治的522例T2DM患者的临床资料,根据颈动脉中膜厚度将患者分为斑块组(274例)与无斑块组(248例)。采用多因素logistic回归及受试者工作特征(receiver operator characteristic,ROC)曲线分析RLP-C水平与T2DM患者颈动脉斑块的关系。结果斑块组甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDLC)、非高密度脂蛋白胆固醇(non-high density lipoprotein cholesterol,non-HDLC)、RLP-C水平显著高于无斑块组,差异有显著性(P<0.05),而高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDLC)水平两组比较差异无显著性(P>0.05)。调整混杂因素后,多因素logistic回归分析显示RLP-C为T2DM患者发生颈动脉斑块的独立危险因素(P<0.01)。ROC曲线分析显示,与LDLC、TG相比,RLP-C水平能够更好地预测T2DM患者颈动脉斑块的发生风险。结论RLP-C水平升高是T2DM患者发生颈动脉斑块的独立危险因素,且与传统血脂指标相比具有更好的预测价值。Objective To investigate the relationship between plasma remnant lipoprotein cholesterol(RLP-C)levels and carotid plaque in patients with type 2 diabetes mellitus(T2DM).Method The clinical data of 522 patients with T2DM admitted to the Department of Endocrinology of Qingdao Municipal Hospital from June 2021 to March 2022 were analyzed retrospectively.According to the intima-media thickness of carotid artery,522 patients were divided into the plaque group(n=274)and non-plaque group(n=248).Multivariate logistic regression and ROC curve were used to analyze the relationship between RLP-C level and carotid plaque in patients with T2DM.Result The levels of triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDLC),non-high density lipoprotein cholesterol(non-HDLC)and RLP-C in plaque group were significantly higher than those in non-plaque group.High density lipoprotein cholesterol(highdensity lipoprotein cholesterol,HDLC)had no significant difference.After adjusting the confounding factors by multivariate logistic regression,RLP-C was an independent risk factor for the occurrence of carotid plaque in patients with T2DM.ROC curve analysis showed that compared with LDLC and TG,RLP-C level could better predict the occurrence of carotid plaque in patients with T2DM.Conclusion RLP-C is an independent risk factor for carotid plaque in patients with T2DM,and it has better predictive value than traditional blood lipids.

关 键 词：残粒脂蛋白胆固醇 2型糖尿病 颈动脉斑块 血脂 

分 类 号：R563.5[医药卫生—呼吸系统]