2型糖尿病患者血清三酰甘油和高密度脂蛋白胆固醇比值与脑白质高信号的相关性  

Correlation between serum triglyceride to high-density lipoprotein cholesterol ratio and white matter hyperintensity in patients with type 2 diabetes mellitus

作　　者：徐汉文 宋迎香[1] 郑佳[1] 张文琼 周洁茹 王祎洁 武晓泓 XU Hanwen;SONG Yingxiang;ZHENG Jia;ZHANG Wenqiong;ZHOU Jieru;WANG Yijie;WU Xiaohong(Department of Endocrinology,Zhejiang Provincial People's Hospital,People's Hospital of Hangzhou Medical College,Hangzhou,Zhejiang 310014,China;不详)

机构地区：[1]浙江省人民医院杭州医学院附属人民医院内分泌科,浙江杭州310014 [2]嘉善县第一人民医院内分泌科,浙江嘉兴314100 [3]蚌埠医学院,安徽蚌埠233030 [4]锦州医科大学,辽宁锦州121001

出　　处：《中国临床研究》2023年第12期1776-1780,共5页Chinese Journal of Clinical Research

基　　金：国家自然科学基金面上项目(81970714);浙江省科技创新领军人才项目(2021R52022);卫生创新人才项目(2021-CXRC07-01);浙江省卫生健康科技计划(2021KY472)。

摘　　要：目的探讨不同Fazekas评分的2型糖尿病(T2DM)患者血清三酰甘油(TG)/高密度脂蛋白胆固醇(HDL-C)比值水平,及其与脑白质高信号(WMH)的相关性。方法收集2021年1至6月在浙江省人民医院内分泌科住院的529例T2DM患者头颅磁共振资料,由专人独立进行Fazekas评分,并按评分分为0级(n=210)、1级(n=257)、2级(n=48)、3级(n=14)四组。并收集一般资料、实验室检查结果进行回顾性横断面研究。采用多元有序logistic回归分析评估TG/HDL-C和Fazekas评分的关系,利用限制性立方样条图拟合TG/HDL-C与WMH发生风险的关系。结果529例患者中WMH阳性患者为319例,占60.3%。0级、1级、2级、3级四组之间性别、年龄、收缩压、舒张压、糖尿病病程、空腹血糖、白蛋白、高血压病史差异有统计学意义(P<0.05)。四组间TG/HDL-C[M(IQR)]比较差异无统计学意义[1.4(1.8)vs 1.4(1.6)vs 1.3(1.1)vs 1.6(1.6),H=5.361,P=0.147]。多元有序logistic回归分析显示,TG/HDL-C与Fazekas评分独立相关(OR=1.119,95%CI:1.031~1.214,P=0.007);多变量调整的限制性立方样条图显示,TG/HDL-C与WMH发生风险呈剂量反应关系。当TG/HDL-C>1.385,发生WMH风险显著增加。结论T2DM患者TG/HDL-C水平与WMH发生风险和严重程度独立相关。Objective To explore the level of serum triglyceride(TG)to high-density lipoprotein cholesterol(HDL-C)ratio in patients with type 2 diabetes mellitus(T2DM)in different Fazekas score,and its correlationship with white matter hyperintensities(WMH).Methods The data of MRI were collected of 529 T2DM patients admitted to the Department of Endocrinology,Zhejiang Provincial People's Hospital from January to June 2021,and Fazekas scores were independently assessed by specialised individuals.The patients were divided into four group according to Fazekas score:grade 0(n=210),grade 1(n=257),grade 2(n=48),and grade 3(n=14).General information and laboratory results were collected for a retrospective cross-sectional study.The relationship between TG/HDL-C and Fazekas score was assessed by multivariate ordinal logistic regression,and the relationship between TG/HDL-C and the risk of WMH was fitted using restricted cubic spline plots.Results Of the 529 patients,319 were WMH positive,accounting for 60.3%.Differences in gender,age,systolic blood pressure,diastolic blood pressure,duration of diabetes,fasting blood glucose,albumin and history of hypertension were statistically significant between the four groups of grade 0,1,2 and 3(P<0.05).There was no significant difference in TG/HDL-C[M(IQR)]among the four groups[1.4(1.8)vs 1.4(1.6)vs 1.3(1.1)vs 1.6(1.6),H=5.361,P=0.147].Multivariate ordinal logistic regression analysis showed that TG/HDL-C was independently associated with Fazekas score(OR=1.119,95%CI:1.031-1.214,P=0.007).Adjusted multivariate restricted cube splines showed that there was a dose-response relationship between TG/HDL-C and the risk of WMH.When TG/HDL-C>1.385,the risk of WMH was increased significantly.Conclusion TG/HDL-C levels are independently associated with the risk and severity of WMH in patients with T2DM.

关 键 词：2型糖尿病 三酰甘油 高密度脂蛋白胆固醇 脑白质高信号 磁共振成像 Fazekas评分 

分 类 号：R587.1[医药卫生—内分泌] R743.3[医药卫生—内科学]