2型糖尿病下肢血管病变相关因素分析

Analysis on related factors of vascular disease in the lower limbs in type 2 diabetes mellitus

目的:探讨2型糖尿病患者下肢血管病变的相关因素。方法:对158例2型糖尿病(T2DM)患者(年龄>40岁,病程>5年)行双下肢血管彩色多普勒超声检查,根据超声结果分为4组:无下肢血管病变组、轻度、中度、重度下肢血管病变组;同时测定血压、糖化血红蛋白(HbA1C)、空腹血糖(FBG)、C肽(FC-Pep)、胰岛素(FIns)、高敏C-反应蛋白(hs-CRP)、血脂,并结合身高、体重、病程等因素,进行统计分析。结果:单因素方差分析结果表明4组间舒张压(DBP)、收缩压(SBP)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、HbA1C、体质指数(BMI)、胰岛素抵抗指数(Homa-IR)、hs-CRP、FC-Pep等因素具有显著性差异(P<0.05)。相关分析表明控制年龄、病程、血压等因素后T2DM患者下肢血管狭窄程度与BMI、Homa-IR、HDL-C、TG、FC-pep、hs-CRP成正相关,与HDL-C成负相关。结论:2型糖尿病下肢血管病变与肥胖,胰岛素抵抗,血脂异常,C肽和炎性因子水平升高密切相关。

Objective： To explore the risk factors of vascular disease in the lower limbs in type 2 diabetics mellitus. Methods： 158 patients with type 2 diabetes mellitus were more than 40 years when diagnosis established, the diabetes duration were more than 5 years and they were divided into four groups according to the results of ultrasonic Doppler examination of the artery of lower limbs were performed. The age, duration, BMI, SBP, DBP, FBG, FC-Pep, HbA1C, HDL-C, LDL-C, TC, TG, Homa-IR and hs-CRP were determined. Results： The results of one-way analysis of variance showed that there was significant difference in their DBP, SBP, BMI,TG, HbAlc, HDL-C,Homa-IR, hs-CRP and FC-Pep among these four groups （P〈0.05）. After controlling their age, course of diabetes and DBP, SBP, the lower limb vasculopathy was positive correlated with BMI, HbA1C, Homa-IR, hs-CRP, TG （P〈0.05） ,respectively; and negative correlated with the level of HDL-C level （P=0.02）. Conclusion： The development of lower limb blood vessel pathological change is closely correlated with BMI, HbA 1 C, Homa-IR, hs-CRP and FC-Pep in T2DM patients.