摘要
目的:临床评估初诊成人隐匿性自身免疫糖尿病(Latent autoimmune diabetes in adults,LADA)心血管疾病风险。方法:初诊糖尿病(Diabetes mellitus,DM)患者,共132例,经糖尿病自身抗体检测后分为LADA组和2型糖尿病(Type 2diabetes mellitus,T2DM)组(其中LADA组60例,T2DM组72例)。同时从体检中心选取与LADA组年龄、体重指数相匹配的健康对照(Normal controls,NC)组46例。观察高敏C反应蛋白(High-sensitivity C-reactive protein,hs-CRP)水平和颈动脉内膜中层厚度(Carotid intima medial thickness,CIMT),比较三组患者之间的hs-CRP、CIMT水平。结果:1.hs-CRP、CIMT水平在LA-DA组显著高于NC组(P<0.01,P<0.05),LADA不伴动脉硬化(Atherosclerosis,AS)组与NC组比较,hs-CRP、CIMT水平升高达统计学差异(P<0.05)。应用hs-CRP水平进行心血管疾病风险分层后,LADA组与NC组比较,心血管疾病风险中、高危组比例明显升高(P<0.001)。2.将hs-CRP、CIMT水平分别在LADA组和T2DM组之间、LADA不伴AS组和T2DM不伴AS组之间比较,未达统计学差异(P>0.05)。LADA组与T2DM组比较AS发生率差异未达统计学意义(P=0.489)。AS斑块发生率在LADA组、T2DM组两组间比较未见统计学差异(P=0.920)。LADA组与T2DM组hs-CRP危险分层,心血管疾病风险中、高危组比较均未见统计学差异(P>0.05,P>0.05)。3.LADA组中,CIMT与LDL-C、FPG、2hPG、HbA1c、hs-CRP均呈显著直线正相关(P=0.001~0.044)。结论:初诊LADA患者hs-CRP、CIMT水平升高,提示心血管疾病风险增加;与初诊T2DM比较心血管疾病风险无显著差异。
Objective:To investigate the cardiovascular disease risk of the newly diagnosed adult latent autoimmune diabetes (LADA). Methods:After determination of diabetes autoantibodies, 132 cases newly diagnosed diabetes were divided into LADA group (n = 60) and type 2 diabetes mellitus (T2DM) group (n = 72). At the same time,46 cases from physical examination center were se-lected in normal controls group (NC group) , whoes age and body mass index matched with LADA group. The high-sensitivity C-reac-tive protein (hs-CRP) level and the carotid intima medial thickness (CIMT) in three groups were compared. Results:l. The concen-tration of hs-CRP and the levels of CIMT in the LADA group was significantly higher than NC group, (P 〈 0.01, P 〈 0.05 ) , and in LADA without atherosclerosis (AS) group also higher than NC group ( P 〈 0.05 ). The risk stratification of cardiovascular disease u-sing the levels of hs-CRP, the percentage of moderate risk group and high risk group in the LADA group was markedly elevated than NC group( P 〈 0. 001, P 〈 0.001 ). 2. Through compared the levels of hs-CRP and CIMT, there were no significant difference between LADA group and T2DM group (P 〉 0.05 ), also were between LADA without AS group and T2DM without AS group( P 〉 0. 05 ). There were no statistical significance between LADA group and T2DM group in the incidence of AS and carotid atherosclerosis plaque( P = 0. 489, P = 0.920) , the proportion of moderate risk group and high risk group of cardiovascular disease between two group were also no significant difference(P 〉0.05, P 〉0.05). 3. In LADA group, LDL-C, FPG, HbAlc, 2hPG, hs-CRP showed a significant linear correlation with CIMT( P = 0. 0014). 044 ). Conclusion:The elevated hs-CRP levels and CIMT levels in newly diagnosed LADA indica-ted that its risk of cardiovascular disease was increased. The hs-CRP and CIMT levels in newly diagnosed LADA and newly diagnosed T2DM was no significant difference .
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2012年第12期1129-1133,1135,共6页
Chinese Journal of Immunology