2型糖尿病患者血清残余胆固醇水平与下肢动脉硬化闭塞症发病的相关性研究  

Association between serum remnant cholesterol levels and the onset of arteriosclerosis obliterans of the lower extremity in patients with type 2 diabetes mellitus

作　　者：吴玉 李长平[2] 邱亚欣 吕元军 WU Yu;LI Changping;QIU Yaxin;LYU Yuanjun(Department of Endocrinology,Tianjin Hospital,Tianjin University,Tianjin 300211,China;Statistics Teaching and Research Office,Tianjin Medical University,Tianjin 300000,China)

机构地区：[1]天津大学天津医院内分泌科,天津300211 [2]天津医科大学统计学教研室,天津300000

出　　处：《重庆医学》2025年第4期938-943,共6页Chongqing Medical Journal

摘　　要：目的探讨2型糖尿病(T2DM)患者血清残余胆固醇(RC)水平与下肢动脉硬化闭塞症(ASO)发病的相关性。方法选取2018年1月至2022年12月在天津大学天津医院内分泌科住院治疗的355例T2DM患者为研究对象,根据患者是否合并ASO分为非ASO组(n=180)和ASO组(n=175)。收集患者一般临床资料和实验室资料,计算RC水平;采用Spearman秩相关分析RC水平与代谢指标的相关性,采用logistic回归分析血清RC水平与T2DM患者并发ASO的相关性。结果与非ASO组比较,ASO组患者年龄更大,糖尿病病程更长,糖尿病周围神经病变、糖尿病肾病、冠心病、高血压、脑梗死的发病率更高,他汀类药物使用率更高,收缩压(SBP)、甘油三酯(TG)、肌酐(Cr)、尿酸(UA)和RC水平也更高,高密度脂蛋白-胆固醇(HDL-C)水平更低,差异有统计学意义(P<0.05)。Spearman秩相关分析结果显示,血清RC水平与TG、总胆固醇(TC)、UA呈正相关(r=0.628、0.289、0.192,P<0.001),与HDL-C呈负相关(r=-0.202,P<0.001)。多因素logistic回归分析显示年龄(OR=1.095,95%CI:1.066~1.124,P<0.001)、糖尿病周围神经病变(OR=1.877,95%CI:1.114~3.162,P=0.018)、糖尿病肾病(OR=2.149,95%CI:1.272~3.629,P=0.004)、SBP(OR=1.017,95%CI:1.004~1.031,P=0.012)和RC(OR=2.644,95%CI:1.569~4.453,P<0.001)是T2DM患者并发ASO的独立影响因素。结论血清高RC水平与T2DM患者并发ASO密切相关。Objective To investigate the correlation between serum remnant cholesterol(RC)levels and the occurrence of arteriosclerosis obliterans(ASO)of the lower extremity in patients with type 2 diabetes mellitus(T2DM).Methods 355 cases of T2DM patients hospitalized in the department of endocrinology of Tianjin Hospital affiliated with Tianjin University from January 2018 to December 2022 were selected and divided into the non-ASO group(180 cases)and the ASO group(175 cases)according to whether the patients were combined with ASO or not.General clinical and laboratory data of patients were collected and RC levels were calculated;Spearman rank correlation analysis was performed to evaluate the correlation between RC levels and metabolic indices,and multivariate logistic regression analysis was conducted to assess the association between serum RC levels and the risk of ASO in T2DM patients.Results Compared with the non-ASO group,the ASO group had older age,the course of diabetes was longer,the incidence rates of diabetic peripheral neuropathy,diabetic nephropathy,coronary heart disease,hypertension,and cerebral infarction were higher,statin use was more frequent,the levels of systolic blood pressure(SBP),triglyceride(TG),creatinine(Cr),uric acid(UA),and RC were higher,and the level of high-density lipoprotein cholesterol(HDL-C)was lower,all differences were statistically significant(P<0.05).Spearman rank correlation analysis showed that serum RC levels were positively correlated with TG,total cholesterol(TC),and UA(r=0.628,0.289,0.192,P<0.001),and negatively correlated with HDL-C(r=-0.202,P<0.001).Multivariate logistic regression analysis revealed that age(OR=1.095,95%CI:1.066-1.124,P<0.001),diabetic peripheral neuropathy(OR=1.877,95%CI:1.114-3.162,P=0.018),diabetic nephropathy(OR=2.149,95%CI:1.272-3.629,P=0.004),systolic blood pressure(OR=1.017,95%CI:1.004-1.031,P=0.012),and RC(OR=2.644,95%CI:1.569-4.453,P<0.001)were independent influencing factors for ASO in T2DM patients.Conclusion Elevated serum RC levels are closely as

关 键 词：2型糖尿病 下肢动脉硬化闭塞症 残余胆固醇 高脂血症 

分 类 号：R587.2[医药卫生—内分泌]