代谢综合征患者颈动脉内膜-中层厚度变化及与动脉粥样硬化程度的关系

Relationship between carotid intima-media thickness and atherosclerosis in patients with metabolic syndrome

目的探讨代谢综合征(MS)患者颈动脉内膜-中层厚度(CAMT)的改变,及其与各种危险因素的关系。方法51例代谢综合征患者,按其血糖水平分为糖耐量减低(MS-IGT)组27例和2型糖尿病(MS-DM)组24例;另选25例健康者为对照组。均行超声检查,测定CAMT,并做血脂、血糖等检查。结果代谢综合征组CAMT高于对照组(P<0.01)。CAMT与年龄、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)、空腹血糖(FPG)、餐后2h血糖(2hPG)、空腹胰岛素(FINS)、2h胰岛素(2hINS)、血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白-B(Apo-B)呈正相关(P<0.01)。多元逐步回归分析,年龄、SBP、DBP、BMI、FPG、2hPG、2hINS、TC、LDL-C与CAMT关系较为密切。结论代谢综合征患者可加速动脉粥样硬化的进展。CAMT能在早期反映高血压、高血糖和高血脂对动脉粥样硬化的促进作用。

Objective To investigate the thickness of carotid intima-media （CAMT） in patients with metabolic syndrome （MS） and the relationship between CAMT and various risk factors. Methods The CAMT was measured by B-mode ultrasonagrapy in 51 patients with metabolic syndromes and 25 healthy controls. According to their plasma glucose level, MS patients were divided into impaired glucose tolerance （MS-IGT） group （n=27） and type 2 diabetes mellitus （MS-DM） group （n=24）, clinical data between the two groups was compared. Results The CAMT was obviously higher in patients with metabolic syndromes than that in the controls （P〈0.01）. A significant relationship between CAMT and patient＇s age, SBP, DBP, BMI（body mass index）, FPG（fasting plasma glucose）, 2hPG（postprandial 2h plasma glucose）, FINS（fasting insulin ）, 2hlNS （postprandial 2h insulin）, TC （ total cholesterol ）, TG （triglyceride）, LDL-C （ low density lipoprotein cholesterol ）, Apo-B （Apopprotein-B） （P〈0.01）. Stepwise regression revealed that ages, SBP, DBP, BMI, FPG, 2hPG, 2hINS,TC, and LDL-C were significant variables associated with CAMT. Condusion Metabolic syndrome can improve the progress of atherosclerosis （AS）. The CAMT can reflect the accelcracted progression of hypertension, high plasma glucose and high blood lipid in the early phase of atherosclerosis.