短病程2型糖尿病大血管病变的相关因素分析

Analysis of correlated factors influencing macroangiopathy in patients with new onset type 2 diabetes mellitus

目的 探讨短病程 2型糖尿病 (T2DM)患者大血管病变的相关因素。方法 2 6 8例短病程T2DM患者 (新诊断或病程在 1年以内 )通过超声波大动脉内中膜厚度 (IMT)检测 ,界定有无动脉粥样硬化 (AS)分为AS组 (10 1例 )和非AS组 (16 7例 ) ,对两组患者的多项临床指标进行比较及相关分析。结果 (1)AS组的年龄、BMI、吸烟指数 (SI)、高血压病程、收缩压、舒张压、总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL -Ch)、C -反应蛋白 (CRP)均高于非AS组(P <0 .0 5 ) ;有DM家族史的比率及胰岛素敏感性指数 (ISI)低于非AS组 (P <0 .0 5 )。 (2 )两组间性别、DM病程、空腹血糖 (FPG)、服糖后 2h血糖 (2hPG)、糖化血红蛋白 (HbA1 c)、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL -Ch)、空腹胰岛素 (FINS)的差异无显著性。 (3)Pearson相关分析 ,提示大动脉平均IMT与年龄 (r =0 .346 ,P <0 .0 0 1)、BMI(r=0 .2 2 9,P =0 .0 0 1)、SI(r =0 .349,P <0 .0 0 1)、收缩压 (r =0 .2 5 8,P <0 .0 0 1)、舒张压 (r =0 .2 0 7,P =0 .0 0 2 )、LDL -Ch(r=0 .178,P =0 .0 0 8)呈显著正相关。结论 短病程T2DM患者合并大血管病变主要与年龄、吸烟、超重或肥胖、高血压、高LDL -Ch血症、胰岛素抵抗 (IR)

Objective To explore the correlated risk factors influencing macroangiopathy in patients with short duration type 2 diabetes mellitus(T2DM).Methods According to arterial intima-media thickness (IMT) measured by color Doppler ultrasonography,268 cases of T2DM diabetic patients(newly diagnosed or with the duration under one year) were divided into two groups: one group was 101 cases with atherosclerosis (AS group) and the other group was 167 cases without AS(non-AS group),compared various clinical data between the two groups and made correlation analysis.Results (1)The age, body mass index (BMI), smoking index (SI), the duration of hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-Ch) and C-reactive protein (CRP) were all significantly higher in the AS group than those in the non-AS group(P<0.05). But the rate of diabetic family history and insulin sensitivity index (ISI) were lower in AS group than in non-AS group(P<0.05).(2)The two groups were similar in sex , diabetes duration, fasting plasma glucose (FPG), post-OGTT 2 hour plasma glucose (2hPG), glycosylated hemoglobin (HbA 1c), fasting insulin (FINS), fasting triglyceride (TG) and high-density lipoprotein cholesterol (HDL-Ch).(3)By pearson analysis of correlation, the IMT mean showed a significant positive correlation with age (r=0.346, P<0.001), BMI (r=0.229, P=0.001), SI ( r=0.349,P<0.001), SBP (r=0.258, P<0.001), DBP (r=0.207, P=0.002),LDL-Ch level (r=0.178, P=0.008).Conclusion The macroangiopathy of short duration type 2 diabetes mellitus is closely associated with age, smoking, overweight or obesity, hypertension and high LDL-Ch level, insulin resistance and CRP.