2型糖尿病患者动脉粥样硬化若干危险因素分析

The Study of Risk Factors of Atherosclerosis Disease in Type 2 Diabetes

目的探讨2型糖尿病发生动脉粥样硬化的危险因素。方法测定170例2型糖尿病患者和74例非糖尿病患者的血清游离脂肪酸、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、空腹血糖、糖化血红蛋白、高敏C反应蛋白、肿瘤坏死因子α、纤维蛋白原,通过病例对照研究比较两组间暴露因素的状况,并对两组动脉粥样硬化发生率进行比较。根据有无动脉粥样硬化将糖尿病患者分组,比较各暴露因素的状况,并对糖尿病动脉粥样硬化危险因素进行多元Logistic回归分析。结果糖尿病患者动脉粥样硬化发生率高于对照组(χ2=15.526,P=0.000,OR=3.088),95%OR可信区间是1.757～5.427。多元Logistic回归分析发现,低密度脂蛋白胆固醇是影响糖尿病动脉粥样硬化的主要危险因素,低密度脂蛋白胆固醇≥2.6mmolL的糖尿病患者动脉粥样硬化发生率是低密度脂蛋白胆固醇<2.6mmolL的糖尿病患者的3倍(χ2=11.987,P=0.001,OR=3.073),95%OR可信区间是1.612～5.860。结论2型糖尿病患者动脉粥样硬化发生率是非糖尿病的3倍,低密度脂蛋白胆固醇是糖尿病发生动脉粥样硬化的高危因素。

Aim To explore the risk factors of atherosclerosis disease in the patients with type 2 diabetes mellitus. Methods Serum free fatty acid （FFA）, total cholesterol （TC）, triglyceride （TG）, low density lipoprotein cholesterol （LDLC）, high density lipoprotein cholesterol （HDLC）, fasting blood glucose （FBG）, glycosylated hemoglobin （HbA1c）, high sensitive Creactive protein （Hs-CRP）, tumor necrosis factor-α （TNF-α）, fibrinogen （FIB） were tested in 170 type 2 diabetics and 74 non-diabetics as control group. These exposing factors and the incidence of atherosclerosis disease were compared in diabetic group and non-diabetic group by case control study. These exposing factors were compared in diabetics with atherosclerosis disease and without atherosclerosis disease and the risk factors of athorosclerosis disease were analyzed in statistic method. incidence of athoresclerosis disease in type 2 diabetics was higher than that in control group （ X^2 = 15.526, P = 0.000, OR = 3. 088 ） and the confidence interval of 95 % OR was 1.757- 5.427. Multivariant Logistic regression analysis showed that the most important risk factor for atherosclerosis disease in type 2 diabetics was LDLC. The incidence of atherosclerosis disease in diabetics whose LDLC was higher than 2.6 mmol/L was 3 times that of whose LDLC was lower than 2.6 mmol/L （ X^2 = 11.987, P = 0. 001, OR=3.073）, and tho confidence interval of 95 % ORwas 1.612-5.860. Conclusion The incidence of atherosclerosis disease in type 2 diabetics was 3 times that in non-diabetics. LDLC was the most important risk factor of atherosclerosis in type 2 diabetics.