2型糖尿病患者桡动脉增强指数影响因素分析

Determinants of radial augmentation index in patients with type 2 diabetes

目的分析2型糖尿病(T2DM)患者桡动脉增强指数(rAI)的主要影响因素,为预防T2DM患者发生动脉硬化和心血管疾病提供依据。方法纳入北京地区参加健康调查的T2DM患者480例,男212例,女268例,年龄27～92(61.5±11.7)岁,其中合并原发性高血压者216例。检测身高、体重、心率、体重指数(BMI)、腰围、血压、总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖、口服葡萄糖耐量试验(OGTT)2h血糖等指标,采用科林HEM-9000AI自动检测仪检测左侧桡动脉rAI,并分析T2DM患者和T2DM合并原发性高血压患者中与rAI相关的影响因素。结果 T2DM患者rAI与年龄、收缩压、脉压、LDL-C呈正相关,与身高、体重、心率、空腹血糖、OGTT2h血糖呈负相关;T2DM合并原发性高血压患者rAI与年龄、脉压呈正相关,与身高、体重、心率、舒张压、空腹血糖呈负相关,女性rAI均高于男性。多元逐步回归分析显示,T2DM患者rAI与性别(β=0.1,P<0.05)、年龄(β=0.1,P<0.05)、身高(β=-0.3,P<0.01)、心率(β=-0.5,P<0.01)和平均动脉压(β=0.1,P<0.01)独立相关,T2DM合并原发性高血压患者rAI与年龄(β=0.2,P<0.01)、身高(β=-0.3,P<0.01)、心率(β=-0.6,P<0.01)独立相关。结论性别、年龄、身高、心率、平均动脉压是T2DM患者rAI的独立影响因素。控制血压对降低T2DM患者的动脉僵硬度至关重要。

Objective To study the determinants of radial augmentation index （rAI） in patients with type 2 diabetes （T2DM）,and explore the means of preventing atherosclerosis and cardiovascular diseases in T2DM patients. Methods Of 480 T2DM patients enrolled in the present study [212 men and 268 women,aged 27-92 years （61.5±11.7 years）],216 were complicated with hypertension. Height,weight,heart rate （HR）,body mass index （BMI）,waistline,blood pressure,total cholesterol,triglycerides,HDL-C,LDL-C,fasting glucose and OGTT2h glucose were measured. The rAI was determined in the left radial artery using tonometry Colin HEM-9000AI. Determinants of radial augmentation index in patients with T2DM including those complicated with hypertension were analyzed using SPSS 13.0. Results Correlation analysis showed that rAI of T2DM had a positive correlation with age,systolic blood pressure （SBP）,pulse pressure （PP） and LDL-C,and a negative correlation with height,weight,HR,fasting glucose and OGTT2h glucose. rAI of T2DM patients with hypertension showed a positive correlation with age,PP and a negative correlation with height,weight,HR,diastolic blood pressure （DBP） and fasting glucose. The rAI was significantly higher in women than in men. Stepwise regression analysis revealed that sex （β=0.1,P0.05）,age （β=0.1,P0.05）,height （β=-0.3,P0.01）,HR （β=-0.5,P0.01） and mean artery blood pressure （MABP,β=0.1,P0.01） were the independent determinants of rAI of T2DM,and age （β=0.2,P0.01）,height （β=-0.3,P0.01） and HR （β=-0.6,P0.01） were the independent determinants of rAI of T2DM with hypertension. Conclusions Sex,age,height,HR and MABP are the independent determinants of rAI of T2DM. It is necessary to take these factors into account when rAI is used as an index for aortic stiffness. The control of BP is very important for patients with T2DM.