新诊断2型糖尿病亚临床动脉粥样硬化发生率及相关危险因素的分析

The prevalence of subclinical atherosclerosis and its risk factors in the newly diagnosed type 2 diabetes

目的探讨新诊断2型糖尿病(DM)患者亚临床动脉粥样硬化发生率及相关危险因素。方法采用无创性高分辨超声血管成像技术筛查2002年6月至10月在卫生部北京医院内分泌科确诊的414例病程≤1年的2型糖尿病患者颈动脉、髂总动脉和股动脉内中膜厚度(IMT)及动脉粥样硬化斑块。分析有无亚临床动脉粥样硬化的两组患者年龄、性别、吸烟、体重指数(BMI)、腰臀比、收缩压、舒张压、空腹血糖(FBG)、餐后2h血糖(PBG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等方面的差异。采用Logistic回归分析各危险因素与亚临床动脉粥样硬化的关系。结果(1)414例患者中,亚临床动脉粥样硬化者165例,占39.8%。(2)亚临床动脉粥样硬化组与无动脉粥样硬化组比较,年龄、收缩压、FBG、PBG、HbA1c、HDL-C差异均有统计学意义。(3)logistic回归分析显示,男性、吸烟、年龄增加、收缩压及PBG升高是亚临床动脉粥样硬化发生的独立危险因素。结论新诊断2型糖尿病患者部分存在亚临床动脉粥样硬化,与多种危险因素有关,须及早控制各种危险因素以防止大血管病变的发生发展。

Objective To investigate the prevalence of subclinical atherosclerosis（AS） and its risk factors in the newly diagnosed type 2 diabetes. Methods Total 414 patients with diabetes（ duration ≤ 1 year）were examined. Noninvasive high resolution B mode uhrasonography was used to measure the intima medial thickness（IMT）, Age, gender, status of smoking, BMI, WHR, SBP, DBP, FBG, PBG, HbA1c, TG, TC, HDL-C and LDL-C were compared between the groups with subclinical AS and those without, Results （ 1 ） 165patients （39. 8% ） showed subclinical AS in 414 patients. （2） There was significant differences in age ,SBP ,FBG ,PBG, HbA1 c and HDL-C between the two groups. （3）Logistic stepwise regression analysis showed that risk factors included was male,smoking, old age, higher systolic blood pressure and PBG. Conclusion Subclinical atherosclerosis is related to many factors. We must control some risk factors earlier to prevent the happening and progress of macroangiopathy.