体质指数对2型糖尿病患者心血管危险因素的影响

Effect of Body Mass Index on Cardiovascular Risk Factors in Patients with Type 2 Diabetes

目的分析体质指数(BM I)对2型糖尿病(DM)患者心血管危险因素的影响。方法随机选取天津医科大学代谢病医院2型DM患者832例,根据BM I分为体重不足组、体重正常组、超重组、肥胖Ⅰ期组、肥胖Ⅱ期组。检测、比较5组收缩压(SBP)、舒张压(DBP)及空腹血浆甘油三酯(TG)、高密度脂蛋白胆固醇(H DL-C)、血清尿酸(UA)、血浆纤维蛋白原(FIB)、空腹血糖(FPG)、胰岛素(INS),H om a-m odel公式计算胰岛素抵抗指数(IRI)。结果不同BM I的2型DM患者SBP、DBP、TG、H DL-C、UA、FIB和IRI有统计学意义(P<0.01),随着BM I的增加高血压、血脂紊乱、高尿酸血症、高纤维蛋白原血症患者(率)显著增加,有统计学意义(P<0.01～0.05)。Pearson相关分析显示,BM I与IRI、SBP、D BP、TG、U A呈正相关,与H DL-C呈负相关,与FIB无相关性。多元逐步回归分析显示,IRI、SBP、D BP、TG与BM I呈显著正相关,H D L-C与BM I呈显著负相关。结论BM I升高导致2型D M患者多种代谢紊乱加重,心血管疾病的危险性增加。

Objective To investigate the effect of body mass index BMI on risk factors for cardiovascular system in patients with type 2 diabetes. Methods 832 patients with type 2 diabetes were randomly divided into underweight group normal weight group outweight group grade 1 obesity group and grade 2 obesity group according to their BMI. Systolic blood pressure SBP diastolic blood pressure DBP fasting plasma triglyceride TG high density lipoprotein cholesterol HDL C serum uric acid UA plasma fibrinogen FIB fasting plasma glucose and insulin FPG and FINS fasting insulin resistance index IRI as calculated by homeostasis model assessment HOMA were determined in all individuals. Results Type 2 diabetic patients with different BMI had significantly different levels in SBP DBP TG HDL C UA FIB and IRI. The prevalences of hypertension dyslipidemia hyperuricemia hyperfibrinogenemia in these patients were significantly increased as BMI increased. Pearson correlation analysis showed that BMI was positively correlated with SBP DBP TG IRI UA and negatively correlated with HDL C but no correlated with FIB. Multiple stepwise regression analysis showed that BMI was positively correlated with SBP DBP TG IRI and negatively correlated with HDL C. Conclusions Increased BMI may lead to worsened metabolic disturbances and increased cardiovascular risks.