体质量指数变异性与慢性冠状动脉综合征合并2型糖尿病患者发生心血管事件的相关性研究  

Correlation between body mass index variability and the risk of major cardiovascular events in patients with chronic coronary syndrome and type 2 diabetes mellitus

作　　者：龚倩[1] 黎东[1] 李郁[1] 罗彩东[1] 赖柱宏 GONG Qian;LI Dong;LI Yu;LUO(Caiqun,LAI Zhuhong Department of Cardiology,Mianyang Central Hospital,Sichuan Province,Mianyang 621000,China)

机构地区：[1]四川省绵阳市中心医院心血管内科,621000

出　　处：《心肺血管病杂志》2023年第12期1226-1231,共6页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探究BMI变异性与慢性冠状动脉综合征(chronic coronary syndrome,CCS)合并2型糖尿病患者发生心血管事件之间的关系。方法:本研究为回顾性研究,选取绵阳市中心医院心内科2018年1月至2022年1月,明确诊断为CCS合并2型糖尿病患者共681例,并根据BMI变异性(变异系数BMI-CV)分为高、中、低三组。收集基线资料、合并疾病、检查检验结果、用药情况等临床资料。进行随访和记录主要心血管事件(major cardiovascular events,MACEs)。使用单因素及多因素Cox回归探究BMI-CV与CCS合并2型糖尿病患者MACEs发生之间的关系。使用Kaplan-Meier法绘制生存曲线比较不同BMI-CV组间MACEs发生率的差异。结果:与低BMI-CV组相比,高BMICV组有更低的舒张压,更高的平均BMI值、更高的TC和吸烟史比例,差异有统计学意义(P<0.05)。经过中位随访时间19.2(11.1~33.6)个月后发现与低BMI-CV组相比,高BMI-CV组MACEs发生率更高。单因素Cox回归分析显示,高BMI-CV组发生MACEs的风险更高(HR=2.14,95%CI:1.28~3.56,P=0.004)。多因素Cox回归在模型1(HR=2.18,95%CI:1.30~3.67,P=0.003)及模型2(HR=2.28,95%CI:1.35~3.85,P=0.002)中均显示高BMI-CV组MACEs发生率更高。生存曲线显示高BMI-CV组MACEs发生率显著高于低BMI-CV组,差异具有统计学意义(Log-rank P<0.05)。结论:高BMICV是CCS合并2型糖尿病患者发生MACEs的独立危险因素。在该人群中,动态的体质量监测和体质量维持对于改善患者的预后有一定的临床意义。Objective:This study aims to explore the relationship between BMI variability and prognosis in patients with chronic coronary syndrome complicated with type 2 diabetes.Methods:This study was a retrospective study.A total of 681 patients diagnosed with chronic coronary syndrome complicated with type 2 diabetes mellitus in January 2018 to January 2022 department of Mianyang Central Hospital Hospital were selected and divided into high,medium and low groups according to BMI variability(coefficient of variation BMI-CV).Clinical data such as baseline data,combined diseases,examination results and drug use were collected.Major cardiovascular events(MACEs)were followed up and recorded.Univariate and multivariate Cox regression were used to investigate the relationship between BMI-CV and the occurrence of MACEs in patients with chronic coronary syndrome complicated with type 2 diabetes mellitus.Kaplan-Meier method was used to draw survival curves to compare the differences in the incidence of MACEs between groups.Results:Compared with the low BMI-CV group,the high BMI-CV group had lower diastolic blood pressure,higher mean BMI at follow-up,higher total cholesterol,and higher smoking history(all P<0.05).After a median follow-up of 19.2(11.1-33.6)months,the incidence of MACEs was higher in the high BMI-CV group than in the low BMICV group.Univariate Cox regression analysis showed that the risk of MACEs was higher in the high BMI-CV group(HR=2.14,95%CI:1.28-3.56,P=0.004).Multivariate cox regression showed a higher incidence of MACEs in the high BMI-CV group in both model 1(HR=2.18,95%CI:1.30-3.67,P=0.003)and model 2(HR=2.28,95%CI:1.35-3.85,P=0.002).The survival curve showed that the incidence of MACEs in the high BMI-CV group was significantly higher than that in the low BMI-CV group,and the difference was statistically significant(Logrank P<0.05).Conclusions:High BMI-CV is an independent risk factor for MACEs in patients with chronic coronary syndrome complicated with type 2 diabetes mellitus.In this population,dynamic wei

关 键 词：体质量指数变异性 慢性冠状动脉综合征 2型糖尿病 主要心血管事件 

分 类 号：R54[医药卫生—心血管疾病]