2型糖尿病患者颈动脉内膜增厚的相关危险因素分析

Related risk factors analysis of type 2 diabetes patients with carotid artery intimal thickening

目的分析2型糖尿病患者颈动脉内膜中层病变及相关危险因素。方法选取符合2型糖尿病诊断标准者2202例,并按照颈动脉内膜中层厚度(CIMT)值进行分组,其中,CIMT≥1 mm为增厚组(1663例),CIMT<1 mm为对照组(539例)。比较两组患者的年龄、性别、收缩压、舒张压、身体质量指数(BMI)、腰臀比、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、血尿酸(UA)、尿蛋白、尿蛋白/肌酐(UACR),分析与CIMT相关的危险因素。结果增厚组患者的年龄、腰臀比、收缩压、FPG、2 h PG、HbA1c、UACR、LDL-C、TC、UA均明显高于对照组,HDL-C明显低于对照组,差异均有统计学意义(P<0.05);年龄、收缩压、TC、HbA1c与CIMT呈正相关(P<0.05),性别、HDL-C与CIMT呈负相关(P<0.05),FPG、2 h PG、BMI、腰臀比、LDL-C、TC、TG、UACR、UA与CIMT无相关性(P>0.05)。结论年龄、收缩压、HbA1c、HDL-C是糖尿病患者颈动脉内膜增厚的独立危险因素。

Objective To analyze the related risk factors of carotid intima-media lesions of patients with type 2 dia- betes disease. Methods 2202 cases of patients met the type 2 diabetes diagnosis standard were selected and they were grouped according to carotid intima-media thickness （CIMT） values,the patients whose CIMT I〉 1 mm were selected as thickened group（1663 cases） and the CIMT〈I mm were selected as normal control group（539 cases）.The levels of age, sex,systolic blood pressure,diastolic blood pressure,body mass index （BMI）,waist hip ratio （WHR）,glyeated hemoglobin （HbAlc）,fasting blood glucose（FPG）,postprandial 2 hours plasma glucose（2 h PG）,total cholesterol（TC）,triglyeerides（TG）, high density lipoprotein eholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,uric acid（UA）,urine protein,uri- nary albumin to creatinine ratio （UACR） between the two groups were compareded,and the risk factors associated with CIMT was analyzed. Results The levels of age,WHR,systolic blood pressure,FPG,2 h PG,HbAlc,UACR,LDL-C,TC and UA in the thickened group were all significantly higher than those of the control group,the level of HDL-C was signifi- cantly lower than that of the control group,and the differences were all statistically significant （P〈O.05）.The age,systolic blood pressure,TC,HbAlc were positively correlated with CIMT （P〈O.05）,and the gender, HDL-C were negatively corre- lated with CIMT and CIMT（P〈0.05）.The FPG,2 h PG,BMI,WHR,LDL- C,TC,TG,UACR and UA was no correlation with CIMT （P〉0.05）. Conclusion Age,systolic blood pressure,HbAlc,diastolic blood pressure and HDL-C were the indepen- dent risk factors of type 2 diabetes patients with carotid artery intimal thickening.