2型糖尿病患者腰臀比与颈部动脉硬化关系的研究

Association between Waist-hip Ratio and Carotid Atherosclerosis in Type 2 Diabetic Mellitus Patients

目的探讨2型糖尿病患者腰臀比与颈部动脉硬化的关系。方法717例2型糖尿病患者进行颈部超声检查，并根据腰臀比的四分位将患者分为4组：第1四分位组（n=178）、第2四分位组（n：180）、第3三四分位组（n=176）和第4四分位组（n=183）。比较4组患者的年龄、糖尿病病程等基本情况及颈部动脉硬化发生率，同时以第1四分位组为参照，分析其余3组患者发生颈部动脉硬化的危险度。最后，运用二元Logistic回归探究腰臀比与颈部动脉硬化发生率之间的关系。结果①4组患者的年龄、吸烟史、糖尿病家族史、体重指数、收缩压、舒张压、甘油三酯、高密度脂蛋白一胆固醇、尿白蛋白／肌酐比值差异有统计学意义（P〈0．05）；②4组患者颈部动脉硬化发生率依次升高，分别为33．7％、45％、47．8％、54．6％，且差异存在统计学意义（P：0．001）；③与第1四分位组相比，其余3组发生颈部动脉硬化的危险度依次是第1四分位组的1．602倍（95％CI：1．042-2．462），1．799倍（95％cI：1．174-2．757），2．369倍（95％CI：1．548-3．627）且差异存在统计学意义（P〈0．05）；④二元Logistic回归显示，在控制其他变量后，腰臀比四分位与颈部动脉硬化发生率有相关性（P〈0．05）。结论有较高的腰臀比的2型糖尿病患者，发生颈部动脉硬化的危险度越大。

Objective To investigate the relationship between waist - hip ratio （WHR） and carotid atherosclerosis in patients with type 2 diabetes mellitus（T2DM）. Methods Totally 717 patients with T2DM were examined for carotid ultrasound, and in accordance with WHR quartiles. These cases were assigned to four groups, the first quartile group （n = 178）, the second quartile group （n = 180） , the third quartile group （ n = 176） and the fourth quartile group （ n = 183 ）. The fundamental conditions including age, duration of diabetes and so on and the prevalence of carotid atherosclerosis among these four groups were compared. Meanwhile, taking the first quartile group as reference, we analyzed odd ratios of carotid atherosclerosis in other three groups. Finally, we applied binary Logistic regression analysis to verify the relationship between WHR quartiles and the prevalence of carotid atherosclerosis. Results ①There were significant differ- ences in age, family history of diabetes, body mass index, systolic blood pressure, diastolic blood pressure, triglyceride, high density li- poproteion - cholesterol as well as urinary albumin creatinine ratio among the four groups （ P all 〈 0.05 ）. ②The prevalences of carotid atherosclerosis in patients of four groups raised gradually, were 33.7% , 45% , 47.8% , 54.6% respectively, and possessed statistical significance（P = O. 001 ）. ③Compared with the first quartile of WHR, the odd ratios of carotid atherosclerosis in other three groups were successively 1.602 times （95% CI： 1. 042 - 2. 462）, 1. 799 times （95% CI：I. 174 - 2. 757） and 2. 369 times （95% CI： 1. 548 - 3. 627 ） , and there was significance among them （ P 〈 O. 05 ）. ④Binary logistic regression analysis showed that it existed significant rela- tionship between WHR quartiles and the prevalence of carotid atherosclerosis. Conclusion The patients with higher waist - hip ratio had higher risk for carotid atherosclerosis in type 2 diabetes mellitus.