目标范围内时间和sdLDL-C水平与2型糖尿病患者发生冠心病的相关性分析  

Correlation Analysis of Time in Range(TIR)and sdLDL-C Levels with the Incidence of Coronary Heart Disease in Type 2 Diabetic Patients

作　　者：左江华[1] 卢懿[2] 吕静[3] 李宗良[4] 田连芳[1] 谷亚楠 郝世瑞 张倩倩 ZUO Jianghua;LU Yi;LV Jing;LI Zongliang;TIAN Lianfang;GU Yanan;HAO Shirui;ZHANG Qianqian(Department of Clinical Laboratory,Xingtai People's Hospital,Xingtai,Hebei 054000,China;Department of Endocrinology,Xingtai People's Hospital,Xingtai,Hebei 054000,China;Department of Cardiology,Xingtai People's Hospital,Xingtai,Hebei 054000,China;Department of Nuclear Medicine,Xingtai People's Hospital,Xingtai,Hebei 054000,China)

机构地区：[1]邢台市人民医院检验科,河北邢台054000 [2]邢台市人民医院内分泌科,河北邢台054000 [3]邢台市人民医院心脏内四科,河北邢台054000 [4]邢台市人民医院核医学科,河北邢台054000

出　　处：《转化医学杂志》2024年第3期381-384,共4页Translational Medicine Journal

基　　金：河北省医学科学研究课题计划(20211222)。

摘　　要：目的 分析葡萄糖目标范围内时间(TIR)和小而密低密度脂蛋白胆固醇(sd LDL-C)水平与2型糖尿病患者发生冠心病的相关性。方法 本研究为回顾性研究,收集2020年12月至2022年1月河北省邢台市人民医院2型糖尿病患者73例作为2型糖尿病组,收集同期2型糖尿病伴冠心病患者54例作为2型糖尿病伴冠心病组。比较2组患者临床资料、sdLDL-C、胆固醇(TC)、甘油三酯(TG)及TIR的差异。采用多因素Logistic回归分析2型糖尿病患者发生冠心病的危险因素。采用受试者工作特征(ROC)曲线评估TIR和sdLDL-C水平对2型糖尿病患者发生冠心病的预测价值。结果 与2型糖尿病患者相比,2型糖尿病伴冠心病组患者年龄、高血压患病率、TG、sdLDL-C明显升高(P <0.05),TIR明显降低(P <0.05)。多因素Logistic回归分析显示sdLDL-C是2型糖尿病患者发生冠心病的独立危险因素。ROC曲线分析显示,TIR和sdLDL-C对2型糖尿病患者发生冠心病的预测曲线下面积(AUC)分别为0.62(95%CI:0.52~0.72,P=0.021),0.649(95%CI:0.555~0.744,P=0.004),两者联合检测,AUC为0.681(95%CI:0.589~0.773,P=0.001)。结论 2型糖尿病伴冠心病患者TIR明显低于2型糖尿病患者,血清sdLDL-C水平明显高于2型糖尿病患者,sdLDL-C是2型糖尿病患者发生冠心病的独立危险因素,TIR联合sdLDL-C对2型糖尿病发生冠心病的预测能力更高。Objective To explore the relationship among time in target range of glucose(TIR),small dense low-density lipoprotein cholesterol(sdLDL-C)levels,and coronary heart disease(CHD)in patients with type 2 diabetes(T2D).Methods This was a retrospective study.We collected data from seventy-three patients with T2D from December 2020 to January 2022,including 40 males and 33 females,with an average age of(53.04±13.82)years.During the same period,we also collected data from fifty-four patients who had both CHD and T2D,including 33 males and 21 females,with an average age of(58.54±10.26)years.Clinical data,sdLDL-C,cholesterol,triglycerides,and TIR were compared between the two groups.Multivariate logistic regression analysis was conducted to identify risk factors for CHD in T2D patients.ROC curve analysis was employed to assess the predictive value of TIR and sdLDL-C for CHD in T2D patients.Results Compared to patients with T2D only,those with both T2D and CHD had significantly higher age,hypertension incidence,triglycerides,and sdLDL-C levels,while TIR was significantly lower(P<0.05).Multivariate logistic regression analysis showed that sdLDL-C was an independent risk factor for CHD in T2D patients.ROC curve analysis revealed an AUC of 0.62 for predicting CHD in T2D patients based on TIR,and an AUC of 0.649 for sdLDL-C.The combined detection of TIR and sdLDL-C improved the predictive ability,with an AUC of 0.681.Conclusion TIR was significantly lower in T2D patients with CHD compared to those without CHD,while serum sdLDL-C levels were significantly elevated.sdLDL-C emerged as an independent risk factor for CHD in T2D patients. The combination of TIR and sdLDL - C demonstrated higher predictive value for CHD in T2D patients.

关 键 词：糖尿病 2型 冠心病 葡萄糖目标范围内时间 小而密低密度脂蛋白胆固醇 LOGISTIC模型 ROC曲线 曲线下面积 

分 类 号：R587.1[医药卫生—内分泌] R541.4[医药卫生—内科学]