绝经后女性2型糖尿病合并冠心病的危险因素分析

Analysis of risk factors in type 2 diabetes mellitus combined with coro-nary heart disease in postmenopausal women

目的 探讨绝经后女性2型糖尿病（T2DM）合并冠心病的主要相关危险因素。方法 选取2012年1月~2014年6月北京市大兴区红星医院内科住院的绝经后女性2型糖尿病患者335例,其中T2DM非合并冠心病组（无冠心病组）157例,T2DM合并冠心病组（冠心病组）178例。收集两组患者的临床资料;检测空腹血糖（FPG）、糖化血红蛋白（Hb A1c）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）及尿酸。结果 冠心病组年龄、糖尿病病程明显高于无冠心病组（P〈0.01）;与无冠心病组比较,冠心病组的FPG、Hb A1c、体重指数、收缩压、TC、LDL-C及TG均升高,HDL-C降低（P〈0.05或P〈0.01）;冠心病组的患者高血压、肥胖、血脂紊乱、颈动脉斑块及脑卒中发病率均高于无冠心病组,差异均有统计学意义（P〈0.05或P〈0.01）;冠心病阳性家族史显著高于无冠心病组（P〈0.01）。Logistic回归分析结果显示,年龄、病程、Hb A1c、LDL-C及收缩压是T2DM合并冠心病的独立危险因素（OR值分别为1.21、1.08、1.49、1.11和1.03,P〈0.05或P〈0.01）。结论 年龄、糖尿病病程、Hb A1c、LDL-C及收缩压与绝经后女性2型糖尿病合并冠心病的发病密切相关。

Objective To investigate the related risk factors of type 2 diabetes mellitus （T2DM） combined with coronary heart disease （CHD） in postmenopausal women. Methods A total of 335 hospitalized postmenopansal women suffering from T2DM without CHD （non-CHD group, 157 cases） and with CHD （CHD group, 178 cases） were enrolled from Jan- uary 2012 to June 2014. Clinical data were collected and the levels of fasting plasma glucose （FPG）, glycated hemoglobin （HbAlo）, triglycerides （TG）, total cholesterol （TC）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C） and blood uric acid （UA） were detected. Results Compared with the non-CHD group,the CHD group showed significantly greater age and longer duration of diabetes （P 〈 0.01）. Further, the CHD group had higher levels of fasting blood glucose, glycosylated hemoglobin, BMI, systolic blood pressure, TC, LDL-C and TG, and lower level of HDL-C （P 〈 0.05 or P 〈 0.01）. The incidences of hypertension, obesity, dyslipidemia, carotid artery plaque, cerebral stroke of CHD group were all higher than those of non-CHD group, the differences were statistically signifi- cant （P 〈 0.05 or P 〈 0.01）. Logistic analysis showed that, age, duration of diabetes mellitus, HbAlc, LDL-C, and sys- tolic blood pressure were the independent risk factors of T2DM combined with coronary heart disease （OR=1.21, 1.11, 1.49, 1.08 and 1.03; P 〈 0.05 or P 〈 0.01）. Conclusion Age, duration of diabetes mellitus, HbAlc, LDL-C, and systolic blood pressure are closely related to the incidence of type 2 diabetes mellitus combined with coronary heart disease in postmenopausal women.