2型糖尿病颈动脉内膜中层厚度相关因素研究

The Study of the Correlation Factors of Carotic Intima-media Thickness (IMT) in Patients With Type 2 Diabetes Meltltus

目的探讨2型糖尿病患者颈动脉内膜中层厚度(IMT)的相关因素。方法检测176例2型糖尿病患者的IMT、甘油三酯(TG)、总胆固醇(TC)、高密度蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、尿微量白蛋白(UAER)、尿微量白蛋白/尿肌酐(UAlb/Cr)值,计算胰岛素抵抗指数(InHOMA-IR),并将IMT与其他因素作相关及多元逐步回归分析。结果 IMT与2hPG、TG、TC、LDL-C、FINS、InHOMA-IR、UAER、UAlb/Cr呈正相关(P<0.05或P<0.01),与HDL-C呈负相关(P<0.01),与FBG、HbA1c不相关(P>0.05)。进入多元线性回归方程的变量为2hPG、LDL-C、BMI、InHOMA-IR、UAER、UAlb/Cr、HDL-C。结论 2型糖尿病患者2hPG、TG、TC、LDL-C、FINS、InHOMA-IR、UAER、UAlb/Cr影响IMT,应针对这些相关因素进行干预,预防或延缓糖尿病大血管并发症。

Objective To investigate the correlation factors of carotid intima-media thickness（IMT） in patients with type 2 diabetes meltltus（T2DM）.Method A total of 178 type 2 diabetic mellitus patients ＇IMT,triglyceride（TG）,total cholesterol（TC）,high-density lipoprotein cholesterol（HDL-C）,low density lipoprotein-cholesterol（LDL-C）,fasting blood glucose（FBG）,2-hour postprandial plasma glucose（2hPG）,fasting insulin（FINS）,insulin resistance index（InHOMA-IR）,urinary albumin excretion rate（UAER） and urinary albumin/creatinine（UAlb/Cr） was measured respectively,correlation analysis and multiple stepwise regression analysis was done between IMT and other factors（P〈0.05） was considered statistically significant.Results There was positive correlation between IMT and 2hPG,TG,TC,LDL-C,FINS,InHOMA-IR,UAER,UAlb/Cr（P〈0.01 or P〈0.05）,and was negative correlation in HDL-C（P〈0.01）,and was noncorrelation in DBP、FBG、HbA1c（P〈0.05）.The variance of equation of multiple linear regression was 2hPG,LDL-C,BMI,InHOMA-IR,UAER,UAlb/Cr,HDL-C.Conclusions Advanced age,having long course of disease,obesity,high diastolic blood pressure,hyperglycemia after 2-hour postprandial plasma glucose,insulin resistance,abnormal urine protein could be important risk factors for atheroscleros.