血清晚期糖基化终末产物检测对2型糖尿病并发症的临床意义及其膳食关联性研究  

Clinical Significance of Serum Late Glycation End Product Detection on Complications of Type 2 Diabetes Mellitus and its Association with Diet

作　　者：刘德胜 郭小佩 郑瑞 陈会 刘清泉 LIU De-sheng;GUO Xiao-pei;ZHENG Rui;CHEN Hui;LIU Qing-quan(Department of Endocrinology,Tangdu Hospital,Air Force Military Medical University,Xi'an,Shaanxi,710000,China)

机构地区：[1]空军军医大学唐都医院内分泌科,陕西西安710000

出　　处：《现代生物医学进展》2024年第21期4099-4106,共8页Progress in Modern Biomedicine

基　　金：全军保健专项科研课题(Vol.20BJZ12)。

摘　　要：目的:探索AGEs作为危险因素与其他临床指标对2型糖尿病并发症各阶段进展的影响,以及膳食营养素摄入、膳食评分与AGEs等危险因素对2型糖尿病并发症各阶段进展的作用。方法:纳入唐都医院内分泌科患者318例,根据2型糖尿病防治指南(2020版)分为单纯组、合并组(微血管病变组、大血管病变组、微血管及大血管病变组),以及健康组30例。对AGEs和其他临床危险因素正态分布与方差齐性检验后、根据结果行参数化与非参数化单因素分析,多元Logistic回归构建依据血清AGEs及危险因素预测2型糖尿病向并发症进展的风险模型、以及AGEs与危险因素之间的多元回归分析。构建营养素、膳食模式评分、AGEs与合并症进展的Spearman秩相关检验与聚类分析。结果:AGEs、年龄、SBP、病程、HCY、SCR、GFR、Cys C、Ca、Apo-B、TC、TG、LDL-C在单纯组与合并组间存在统计学差异(P<0.05)。AGEs、心率、年龄、SBP、病程、HCY、SCR、GFR、Cys C、Apo-B、TC、HDL-C、LDL-C在单纯组、微血管组、大血管组、微血管与大血管组间存在统计学差异(P<0.05)。多因素Logistic回归分析显示,年龄增加、心率升高、病程延长、Cys C升高为2型糖尿病合并症的独立危险因素,AGEs升高、Ca升高为独立保护因素。变量间多元线性回归分析发现、BMI、Ca、ALT、DBP对AGEs存在负向影响,GFR、AST、TC、病程对AGEs存在正向影响(P<0.05)。相关性分析发现AGEs与HEI-总分、AHEI-总分、DBI-2022负向分密切相关。聚类分析提示,AGEs与HEI、AHEI距离较近。结论:AGEs及多种临床因素对2型糖尿病单纯及并发症进展存在一定作用,并且多种膳食模式评分结合AGEs、能评估健康人群向2型糖尿病及其合并症进展风险、给予膳食层面上更加具体的指导与改善。Objective:To explore the effects of AGEs as risk factors and other clinical indicators on the progression of type 2 diabetes complications at different stages,and the effects of risk factors such as dietary nutrient intake,dietary score and AGEs on the progression of type 2 diabetes complications at different stages.Methods:A total of 318 patients from the Department of Endocrinology of Tangdu Hospital were enrolled and divided into simple group,combined group(microvascular disease group,macrovascular disease group,microvascular and macrovascular disease group),and healthy group(30 cases)according to the guidelines for the prevention and treatment of type 2 diabetes mellitus(2020 edition).After the homogeneity test of normal distribution and variance of AGEs and other clinical risk factors,parametric and non-parametric univariate analysis was performed according to the results,and multiple logistic regression was constructed to predict the risk model of type 2 diabetes mellitus progression to complications based on serum AGEs and risk factors,and multiple regression analysis between AGEs and risk factors.A Spearman rank correlation test and cluster analysis were constructed for nutrient content,dietary pattern scores,AGEs and comorbidity progression.Results:There were statistically significant differences in AGEs,age,SBP,course of disease,HCY,SCR,GFR,CysC,Ca,Apo-B,TC,TG,and LDL-C between the simple group and the combined group(P<0.05).There were statistically significant differences in AGEs,heart rate,age,SBP,course of disease,HCY,SCR,GFR,CysC,Apo-B,TC,HDL-C,and LDL-C among the simple group,microvascular group,macrovascular group,and microvascular and macrovascular groups(P<0.05).Multivariate Logistic regression analysis showed that increasing age,increased heart rate,prolonged disease course,and elevated CysC were independent risk factors for type 2 diabetes comorbidities,while elevated AGEs and elevated Ca were independent protective factors.Multiple linear regression analysis showed that BMI,Ca,ALT and DBP had

关 键 词：2型糖尿病 2型糖尿病并发症 晚期糖基化终末产物(AGEs) 半定量食物频率问卷(SQFFQ) 

分 类 号：R587.2[医药卫生—内分泌] R195.4[医药卫生—内科学]