老年人糖尿病与动脉粥样硬化的相关性研究

Correlation between diabetes mellitus and atherosclerosis in the elderly

目的探讨老年2型糖尿病患者血液生化指标、糖化血红蛋白水平以及血清胆红素水平与动脉粥样硬化的关系。方法将100例老年2型糖尿病患者按照颈动脉的病变程度分为2型糖尿病合并颈动脉粥样硬化组（糖尿病＋动脉硬化组）和单纯糖尿病组，分别对受试者测定血液生化指标、糖化血红蛋白水平以及血清胆红素水平。同时与60例健康老年人（对照组）进行比较。结果糖尿病＋动脉硬化组与单纯糖尿病组比较，总胆固醇[（5．86±0．28）mmol／I，比（4．63±0．32）mmol／L，t=20．913、三酰甘油[（2．02±0．43）mmol／L比（1．56±0．39）mmol／L，t=5．543、低密度脂蛋白胆固醇[（3．74±0．76）mmol／L比（3．03±0．81）mmol／L，t=4．51]和脂蛋白Lp（a）[（297．3±102．2）mmol／L比（203．5±110．4）mmol／L，t=4，403均升高（均P〈0．05）。糖尿病＋动脉硬化组糖化血红蛋白（9．58±0．47）mmol／L高于单纯糖尿病组（7．21±0．66）mmol／I．（t=20．9，P〈0．05），糖尿病＋动脉硬化组和单纯糖尿病组糖化血红蛋白均高于对照组（P〈0．05）。糖尿病＋动脉硬化组血清胆红素水平（8．02±1．23）μmol／L，低于单纯糖尿病组（13．72±1．64）μmol／L（t=19．8）和对照组（19．66土1．41）／μmol／L（t=47．0），差异均有统计学意义（均P〈0．05）。结论糖化血红蛋白、血清胆红素降低可能促进了老年2型糖尿病患者动脉粥样硬化的发生，控制糖化血红蛋白水平、血脂水平有助于减少老年2型糖尿病患者动脉粥样硬化的形成，对于糖尿病的预防以及治疗具有重要的临床意义。

Objective To investigate the relationship between blood biochemical indicators levels （glycosylated hemoglobin and serum bilirubin） and atherosclerosis in elderly type 2 diabetic. Methods Totally 100 type 2 diabetic patients aged 62-85 years were divided into type 2 diabetes mellitus with carotid atherosclerosis group （T2DM AS group, n= 55） and type 2 diabetes mellitus group （T2DM group, n 45）. Blood biochemical indicators levels （glycosylated hemoglobin and serum bilirubin） were determined and compared between the patients and the healthy controls （n= 60） Results Serum levels of total cholesterol, triglyceride, low-density lipoprotein and Lp（a） were elevated inT2DM-AS group as compared with T2DM group 〈（5.86±0.28） mmol/L vs. （4.63±0.32） mmol/L, （2.02± 0.43） retool/L） v.s. （1.56 ±0.39） mmol/L, （3.74 ±0.76） mmol/L us. （3.03±0.81） mmol/Land （297.3±102.2） mmol/Lvs. （203.5±110.4） mmol/L, t=20.91, 5.54, 4.51 and 4.40, all P〈O. 065. Glycosylated hemoglobin level was higher in T2DM-AS and T2DM groups than in control group 〈（9.58 ± 0.47 ） mmol/I., （7.21 ±0.66 ） mmol/L vs. （5.31 ±0.54 ） mmol/L, both P〈0.05）. There was a significant difference in glycosylated hemoglobin level between T2DM-ASgroup and T2DM group 〈（9.58±0.47） mmol/L vs. （7.21±0.66） mmol/L, t=20.9, P〈0.05）. Serum bilirubin level was lower in T2DM AS group than in T2DM and control groups （8. 02±1. 23）μmol/L vs. （13.72±1.64）μmol/L, （19.66±1.41）/μmol/I.; t=19.8, 47.0, both P 〈0. 051. Conclusions Glycosylated hemoglobin and serum bilirubin may promote atherosclerosis in elderly type 2 diabetic. The control of glycosylated hemoglobin and blood lipids levels may help to reduce atherosclerosis in elderly type 2 diabetic patients, which has the important clinical significance for the prevention and treatment of type 2 diabetes mellitus.