2型糖尿病合并牙周病患者动脉粥样硬化相关因素分析

Analysis on correlative factors of atherosclerosis in patiens with type 2 diabetes mellitus and periodontitis

目的为2型糖尿病合并牙周病患者动脉粥样硬化的防治提供依据。方法采用彩超测定60例2型糖尿病合并牙周病患者(观察组)及50例无牙周病的糖尿病患者(对照组)的颈动脉内膜—中膜厚度(IMT);取其血液标本,葡萄糖氧化酶法测空腹血糖(FPG),ELISA法测定空腹胰岛素(FINS),酶比色法测定TG、TC、HDL-C、LDL-C,免疫比浊法测定C反应蛋白(CRP),ELISA法测定可溶性细胞间黏附分子-1(sICAM-1),同时计算BMI、胰岛素抵抗指数(HOMA-IR),对IMT与上述指标行Pearson相关分析和多元线性逐步回归分析。结果观察组FPG、FINS、TG、CRP、sICAM-1、IMT、HOMA-IR水平均明显高于对照组,而HDL-C水平明显低于对照组(P<0.05或P<0.01)。直线相关分析示IMT与年龄、FPG、TC、TG、LDL-C、FINS、HOMA-IR、CRP、sICAM-1、BMI呈正相关(P<0.05或P<0.01),与HDL-C呈负相关(P<0.01)。多元线性逐步回归分析示IMT与HOMA-IR、CRP、LDL-C呈正相关。结论血清CRP水平升高是影响2型糖尿病合并牙周病患者动脉粥样硬化的独立危险因素之一。

Objective To provide basis for the prevention and cure of atherosclerosis in patiens with type 2 diabetes mellitus and periodontitis.Methods The intima-media thickness（IMT） was examined in 60 patiens with type 2 diabetes mellitus and periodontitis（observed group） and 50 patiens with type 2 diabetes mellitus（control group）;serum sample were taken from the two groups,the fasting plasma glucose（FPG） was detected by glucose oxidase method,the fasting insulin（FINS） was detected by ELISA method,and the total cholesterol（TC）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C） were detected by enzymes colorimetric method,the C reactive protein（CRP） was detected by immunoturbidimetry method,the soluble cellular adhesion molecule-1（sICAM-1） was measured by ELISA method.Body mass index（BMI） and homeostasis model assessment of insulin resistance（HOMA-IR） were calculated.Pearson correlation analysis and multiple stepwise regression analysis were used.Results The levels of FPG,FINS,TG,CRP,sICAM-1,IMT,HOMA-IR in the observed group were significantly higher than those in the control group,and the level of HDL-C was significantly lower than that in the control group（P0.05 or P0.01）.Pearson correlation analysis indicated that IMT was positively correlated with age,FPG,TC,TG,LDL-C,FINS,HOMA-IR,CRP,sICAM-1,BMI（P0.05 or P0.01）,but was negative correlated with HDL-C（P0.01）.Multiple stepwise regression analysis indicated that IMT was positively correlated with HOMA-IR,CRP and LDL-C were independent factors that affect IMT.Conclusions C reactive protein was a independent risk factor of atherosclerosis in patients with type 2 diabetes and periodontitis.