2型糖尿病颈动脉硬化的影响因素分析

Analysis of the factors affecting carotid arterial atherosclerosis in type 2 diabetes mellitus

目的分析2型糖尿病颈动脉粥样硬化(CAA)的影响因素。方法用B型超声对110例2型糖尿病患者测定颈动脉壁厚度和局部动脉粥样硬化病变。CAA病变分为4组:正常组、肥厚组、稳定和不稳定斑块组。测定患者的空腹胰岛素、胰岛素原、VCAM-1、HbA1c、TC、TG、LDL-C、HDL-C、C-RP和尿白蛋白。分析以上因素与颈动脉粥样硬化分级的关系。结果4组间血胰岛素、胰岛素原、HbA1c、BMI、C-RP和尿白蛋白等指标的差异无统计学意义。正常组的TC、TG、LDL-C、HDL-C和VCAM-1水平低于其余3组。多元线性回归分析结果显示颈动脉分级与年龄、TG、LDL-C和VCAM-1等明显相关。结论VCAM-1水平可能是糖尿病大血管病变的标志物。

Objective To discuss factors affecting carotid arterial atherosclerosis in type 2 diabetes mellitus. Methods The corotid arterial （CA） wall thickness and local atherosclerosis lesions were determined in 110 cases with T2DM by B-mode ultrasonography. The CA lesions of 110 cases were divided into four groups： normal, incrassation, stable and unstable plaques. The fasting levels of serum insulin, proinsulin, sVCAM-1, HbAlc, TC, TG, LDL-C, HDL-C, CRP and albuminuria were determined. The relationship of these factors with the grade of carotid arterial atherosclerosis was ana- lyzed. Results The levels of insulin, proinsulin, HbA1c, BMI, CRP and albuminuria showed no significant difference among four groups. The levels of TC, TG, LDL-C, HDL-C and sVCAM-1 were lower in normal group than those in other three groups. Multiple linear regression showed that the grade of carotid arteries was correlated with age, TG,LDL-C and sVCAM-1. Conclusions The level of sVCAM-1 is likely to be a marker of the diabetic complications.