正常高值血压中青年男性合并糖尿病对动脉僵硬度的影响

Effect of diabetes on arterial stiffness in middle-aged male subjects with prehypertension

目的探讨合并2型糖尿病(T2DM)对正常高值血压者臂踝脉搏波传导速度(baPWV)及颈动脉内膜中层厚度(CIMT)的影响。方法从2010年5月～2011年5月在杭州疗养院疗养或健康体检的中青年男性中,选取正常高值血压且合并T2DM患者64例,单纯正常高值血压者70例及理想血压66例。所有对象均检测颈动脉CIMT、baPWV以及血液生化指标。结果与理想血压组比较,单纯正常高值血压组CIMT及baPWV均增高,分别为(0.78±0.10)mm vs(0.73±0.08)mm及(1318.4±132.5)cm/s vs(1232.5±121.2)cm/s;与单纯正常高值血压组比较,正常高值血压合并T2DM组CIMT及baPWV也显著增高(0.84±0.13)mm vs(0.78±0.10)mm,(1406.7±139.8)cm/s vs(1318.4±132.5)cm/s,差异均有显著统计学意义(P<0.01)。Logistic回归分析,T2DM及空腹血糖增高是正常高值血压男性颈动脉CIMT和baPWV增高的独立危险因素,其中baPWV增高的OR及95%CI分别为3.49(1.67～7.34)及2.32(1.24～4.34)。结论正常高值血压合并T2DM者动脉僵硬度进一步增加,提示对该人群可能需调整正常高值血压的定义并强化干预措施。

Objective To investigate the effect of type 2 diabetes（T2DM） on brachial-ankle pulse wave velocity（baPWV） and carotid intima-media thickness（CIMT）.Methods Middle-aged male subjects who received health check-up in our hospital from May 2010 to May 2011 were screened out,including 64 cases of prehypertension（120～139/80～89 mmHg） with T2DM,70 cases with isolated prehypertension and 66 cases with normotension（120/80 mmHg）;all subjects underwent baPWV and CIMT tests.Results Compared with the normotensive group,the isolated prehypertensive group had higher levels of CIMT and baPWV,（0.78±0.10） mm vs（0.73±0.08） mm and（1318.4±132.5） cm/s vs（1232.5±121.2） cm/s（P0.01）;compared with the isolated prehypertensive group,the prehypertension with T2DM group had significantly higher levels of CIMT and baPWV,（0.84 ±0.13）mm vs（0.78 ±0.10）mm and（1406.7±139.8） cm/s vs（1318.4±132.5） cm/s（P0.01）.The logistic regression analysis indicated that T2DM and the level of plasm fast glucose were the independent risk factors of the elevation of baPWV and CIMT in male subjects with prehypertension,OR and 95%CI with elevation of baPWV was 3.49（1.67～7.34） and 2.32（1.24～4.34）,（P0.01）,respectively.Conclusions Prehypertensive subjects with T2DM have increased arterial stiffness.The definition of prehypertension for patients with T2DM should be adjusted and intensified intervention may be needed.