TG/HDL-C比值预测2型糖尿病下肢动脉硬化的价值

The value of the ratio of TG/HDL-C in prediction about low limb atherosclerosis in type 2 diabetes

目的探讨2型糖尿病患者下肢动脉硬化与三酰甘油/高密度脂蛋白胆固醇(TG/HDL-C)比值的关系,寻找监测下肢动脉硬化的标志物。方法彩超测量糖尿病患者足背动脉内膜厚度(IMT),以IMT≥0.7 mm分为糖尿病动脉硬化组,<0.7 mm为糖尿病非动脉硬化组。比较两组年龄、糖尿病病程、收缩压、舒张压、空腹及餐后血糖、糖化血红蛋白、血胆固醇、TG/HDL-C比值、低密度脂蛋白、体质量指数、纤维蛋白原、超敏C反应蛋白、吸烟的差别,多元线性回归及ROC曲线对主要的危险因素进行评估。结果糖尿病动脉硬化组年龄、糖尿病病程、收缩压、餐后血糖、糖化血红蛋白、TG/HDL-C比值、超敏C反应蛋白高于非动脉硬化组。多元线性回归分析示TG/HDL-C比值是独立的糖尿病下肢动脉硬化的主要危险因素,ROC曲线分析示TG/HDL-C比值曲线下面积为0.71,界定值为0.11,灵敏度为0.77,特异度为0.61。结论 TG/HDL-C比值升高是糖尿病患者下肢动脉硬化的危险因素,比值>0.11时,提示糖尿病下肢动脉硬化,TG/HDL-C比值可作为糖尿病下肢动脉硬化的标志物。

Objective To explore the correlation between low limb atherosclerosis in type 2 diabetes and the ratio of triacylglycerol/high-density lipoprotein cholesterol（TG/HDL-C） and research on the marker of low limb atherosclerosis during the monitoring.Methods The endarterium thicknesses of low limb IMT in patients with T2DM were detected by color doppler ultrasound.The patients were divided into low limb atherosclerosis in diabetes group（IMT≥0.07mm） and non atherosclerosis group（IMT0.07mm）.The age,diabetic history,SBP,diastolic pressure,Fasting and postprandial blood glucose,HbA1C,cholesterolemia,ratio of TG/HDL-C,low density lipoprotein,baric index,fibrinogen,HsCRP,differences in smoking,multiple linear regression and ROC curve were compared between two groups and used to evaluate the risk factors.Results Patients with low limb atherosclerosis in diabetes showed a significantly higher age,diabetic history,SBP,postprandial blood glucose,HbA1C,the ratio of TG/HDL-C,HsCRP than that of non atherosclerosis group.The multiple linear regressions revealed that the ratio of TG/HDL-C was the most important predictive risk factors.ROC analysis showed that the AUC of the ratio of TG/HDL-C was 0.71,the cut-off value was 0.11,the sensitivity was 0.77,and the specificity was 0.61.Conclusion The increasing ratio of TG/ HDL-C is the main risk factor contributing to low limb artherosclerosis.When the ratio exceeds 0.11,it can be proposed as an easily obtainable atherogenic marker for low limb atherosclerosis in type 2 diabetes.