内脏脂肪指数、血红蛋白及促甲状腺激素水平与2型糖尿病心脏自主神经病变的相关性  

Correlation of visceral fat index,hemoglobin and thyroid stimulating hormone levels with cardiac autonomic neuropathy in type 2 diabetes mellitus

作　　者：赵丽娟 Zhao Li-juan(Department of Endocrinology,Anyang Regional Hospital,Anyang 455000,Henan,China)

机构地区：[1]濮阳市安阳地区医院内分泌科,河南安阳455000

出　　处：《四川生理科学杂志》2024年第12期2724-2727,2731,共5页

摘　　要：目的:探讨内脏脂肪指数、血红蛋白及促甲状腺激素水平与2型糖尿病心脏自主神经病变(Diabetic Cardiac Autonomic Neuropathy in Type 2 Diabetes,DCAN)的相关性。方法:选取2023年2月至2024年5月期间本院收治的118例2型糖尿病患者作为研究对象。根据患者是否发生DCAN,将患者分为DCAN组(68例)和非DCAN组(50例)。收集患者的临床资料,分析组间内脏脂肪指数、血红蛋白及促甲状腺激素水平的差异,探讨影响2型糖尿病患者DCAN发生的因素。结果:DCAN组内脏脂肪指数、促甲状腺激素水平均明显高于非DCAN组,血红蛋白水平明显低于非DCAN组(P<0.05)。DCAN组的糖尿病病程明显长于非DCAN组,吸烟患者占比明显高于非DCAN组,糖化血红蛋白、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、尿微量白蛋白/肌酐水平均明显高于非DCAN组,游离四碘甲腺原氨酸水平明显低于非DCAN组(P<0.05)。内脏脂肪指数、血红蛋白、促甲状腺激素、糖化血红蛋白、低密度脂蛋白胆固醇均为DCAN发生的影响因素。建立预测模型,其AUC值为0.908(95%CI:0.855-0.962),最佳截断值为36.126,敏感度为0.809,特异度为0.900。结论:内脏脂肪指数和促甲状腺激素水平升高及血红蛋白水平降低会增加T2DM患者发生DCAN的风险,根据多因素分析建立的DCAN发生模型,可以有效预测DCAN的发生。Objective:To investigate the correlation of visceral fat index,hemoglobin and thyrotropin levels and cardiac autonomic neuropathy(DCAN)in type 2 diabetes mellitus.Methods:118 patients with type 2 diabetes admitted to our hospital from February 2023 to May 2024 were selected as the study objects.Patients were divided into DCAN group(68 cases)and non-DCAN group(50 cases)according to whether developed to DCAN.The clinical data of patients were collected,the differences of visceral fat index,hemoglobin and thyrotropin levels between groups were analyzed,and then the factors affecting the occurrence of DCAN were explored in patients with type 2 diabetes.Results:Visceral fat index and thyroid stimulating hormone level in DCAN group were significantly higher than those in non-DCAN group,and hemoglobin level was significantly lower than that in non-DCAN group(P<0.05).The duration of diabetes in DCAN group was significantly longer than that in non-DCAN group,the proportion of smoking patients was significantly higher than that in non-DCAN group,the levels of glycosylated hemoglobin,fasting blood glucose,total cholesterol,low density lipoprotein cholesterol,urinary microalbumin/creatinine were significantly higher than those in non-DCAN group,and the level of free tetraiodothyronine was significantly lower than that in non-DCAN group(P<0.05).Visceral fat index,hemoglobin,thyrotropin,glycosylated hemoglobin and low density lipoprotein cholesterol were the factors influencing DCAN.The predictive model was established with an AUC value of 0.908(95%CI:0.855-0.962),an optimal cut-off value of 36.126,a sensitivity of 0.809,and a specificity of 0.900.Conclusion:The increased visceral fat index and thyroid stimulating hormone level,and the decreased hemoglobin level increase the risk of DCAN in T2DM patients.The occurrence model of DCAN based on multivariate analysis can effectively predict the occurrence of DCAN.

关 键 词：内脏脂肪指数 血红蛋白 促甲状腺激素 2型糖尿病 心脏自主神经病变 

分 类 号：R587.1[医药卫生—内分泌]