2型糖尿病大血管病变相关因素多元回归分析——餐后甘油三酯水平增高可能为独立危险因素

Multiple stepwise logistic regressive analyses of diabetic macrovascular complications-postprandial hypertriglyceride may be as an independent risk factor

目的 探讨影响 2型糖尿病大血管病变的危险因素。方法 初诊 2型糖尿病 2 6 8例按是否合并大血管病变分为病变组 (98例 )及对照组 (170例 ) ,对其进行混合餐负荷试验及其相关的临床观察 ,筛选相关因素进行多元逐步L ogistic回归分析。结果 病变组体重指数 (BMI) 2 5 .6 6± 1.78kg/ m2 较对照组 2 3.0 4± 1.6 8kg/ m2 增高 (P <0 .0 5 ) ;病变组餐后 4小时 TG水平 3.2 3± 0 .89mmol/ L 较对照组 1.99± 0 .79mmol/ L 增高 (P <0 .0 5 ) ;将 2 6 8例受试者作为整体 ,以大血管病变作为应变量 Y(有 =1;无 =0 ) ,以年龄、BMI、收缩压 (SBP)、舒张压 (DBP)、糖化血红蛋白 (Hb A1c)、空腹胰岛素 (FINS)、空腹 TG、TC、L DL- C、HDL- C及餐后 4小时甘油三酯 (TG4 h)共 11个因素为自变量 ,进行多元逐步L ogistic回归分析 ,入选的变量是 TG4 h和 BMI。结论 提示餐后甘油三酯水平增高与糖尿病大血管病变独立显著相关 。

Objective To explore whether postprandial hypertriglyceride is an independent risk factor of diabetic macrovascular complications.Methods In 268 cases with type 2 diabetes in which 98 patients with macrovascular complications and 170 without, plasma glucose, insulin and triglyceride were measured before and 2 and 4 hours after a test meal. Screening out the factors that are relative to diabetic macrovascular complications were analyzed with the way of multiple stepwise logistic regressive analyses.Results BMI was 25 66±1 78 kg/m 2 in pathological group which is higher than 23 04±1 68 kg/m 2 in the controls (P<0 05); The concentrations of triglyceride 4 hours after test meal was higher in pathological group than in the controls (3 23±0 89mmol/L vs 1 99±0 79mmol/L, P<0 05); To define the independent association between postprandial hypertriglyceride and other risks status of macrovascular complications, multiple stepwise logistic regressive analyses were used with age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood perssure (DBP), HbA1c, fasting insulin (FINS), fasting triglyceride (TG), total cholesterol (TC), LDL C,HDL C and postprandial TG4h. Postprandial TG4h and but not other parameters related independently and significantly with macrovascular complications, so did BMI. Conclusion The study suggested that postprandial hypertriglyceride is an independent risk factor of diabetic macrovascular complications and dyslipoidoses in type 2 diabetes should be treated well.