老年代谢综合征患者的临床特点分析

Clinical Characteristics of the Elderly with Metabolic Syndrome

目的探讨老年2型糖尿病患者合并代谢综合征(MS)的临床特征及对糖尿病大血管病变及肾脏损害的影响。方法选择2型糖尿病患者257例,分为合并代谢综合征组(MS组,120例)和非代谢综合征组(非MS组,137例),对比分析2组患者的临床资料及冠状动脉粥样硬化性心脏病(简称冠心病)、下肢动脉硬化、脑梗死的发病情况。结果代谢综合征组患者的体质量指数(BMI)、胰岛素抵抗值、胆固醇、三酰甘油均较非代谢综合征组明显增高,MS组β细胞功能较非MS组差,差异有统计学意义(P<0.01);代谢综合征组患者尿酸及尿白蛋白排泄率较非代谢综合征组均明显增高,差异有统计学意义(P<0.01),代谢综合征组冠心病的发病比例显著高于非代谢综合征组(P<0.05)。结论与非代谢综合征组的老年2型糖尿病患者比较,合并代谢综合征患者的β细胞功能较差、胰岛素抵抗及肾脏损害较重,冠心病发生率更高。

Objective To investigate clinical characteristics of the elderly with metabolic syndrome and type 2 diabetes and the influence of metabolic syndrome on coronary heart disease and chronic renal disease. Methods The study was conducted in 257 patients （ age range 60-85 years） with type 2 diabetes mellitus. The patients were divided into two groups which were with or without MS according to the Adult Treatment Panel Ⅲ criteria ：120 patients with MS and 137 patients without MS. The clinical features and morbidity of coronary heart disease, arteriosclerosis of the lower extremity, and cerebral infarction. Results Compared with patients without MS, BMI, HOMA-β, total cholesterol, triglyceride, uric acid and microalbuminuria of patients with MS were significantly higher（ all P 〈 0.01 ）. Compared with patients without MS, more patients with MS suffered from CHD （ P 〈 0.01 ）. Conclusion Obesity, dyslipidemia, insulin resistance, hyperuricacidemia, microalbuminuria and CHD were more common in the elderly with MS and type 2 diabetes.