老年糖尿病高危人群易发动脉粥样硬化的相关危险因素分析

Related risk factors of atherosclerosis in elderly high diabetic risk population

目的探讨老年糖尿病高危人群动脉粥样硬化(AS)的发生情况及相关危险因素。方法使用75 g口服葡萄糖耐量试验将60岁以上有血糖升高倾向的87例患者分为糖耐量正常(NGT)组25例,糖耐量低减(IGT)组25例,糖尿病(DM)组37例,进行颈动脉超声及相关指标的检测。结果NGT组I、GT组、DM组颈动脉内膜异常者分别为12例(48.0%)、18例(72.0%)、34例(91.1%);AS的发生频率分别为2例(8.0%)、6例(24.0%)、13例(35.1%),P<0.05。logistic多元回归分析显示年龄、胆固醇、低密度脂蛋白胆固醇、空腹血糖、负荷后2 h血糖是AS发生的独立危险因素。结论年龄、血脂异常、高血糖是老年DM高危人群发生AS的独立危险因素。

Objective To analyse the possible risk factors of atherosclerosis in elderly high diabetic risk population. Methods Elderly individuals who previously had abnormal glycemia but were non-diabetic were recruited. All subjects underwent 75 g oral glucose tolerance test （OGTT） and were divided into normal glucose tolerance（NGT） （ n = 25）, impaired glucose tolerance（IGT） （ n = 25） and diabetes mellitus（Dn） （ n = 37） groups. Fasting blood samples were taken for examination of lipid profile, adiponectin, MDA, CLIP, PAI-1, etc. Carotid arteries were examined by B-uhrasonography. Results In NGT, IGT and DM groups, the numbers of cases with abnormal intima smoothness were 12（48.0% ）, 18（72.0% ） and 34（91.1% ）, and the numbers of subjects having atherosclerosis were 2 （8.0 % ）, 6 （24.0 % ） and 13 （35.1% ） respectively, P = 0.05. Multivariate logistic regression analysis showed that age, cholesterol, LDL-C, fasting glucose and 2-hour OGTT were independently associated with risk of athcrosclerosis. Conclusion Atherosclerosis is serious following the deteriorated glucose metabolism. Age, abnormal blood lipids and high blood glucose are independent risk factors of atherosclerosis.