新发2型糖尿病患者下肢动脉硬化与胱抑素C水平的相关性分析

Correlation between lower limb arteriosclerosis and Cystatin C level in newonset type 2 diabetes

目的：探讨新发2型糖尿病患者（T2DM）患者下肢动脉硬化发生的危险因素,分析胱抑素C（CysC）与T2DM患者下肢动脉硬化的相关性。方法：回顾性分析本院2011-2014年住院的新发T2DM 68例,其中踝肱指数（ABI）为0.9~0.7者26例（A组）,ABI为0.5~0.7 24例（B组）,ABI〈0.5 18例（C组）,比较各组患者的身高、体重、血压、血糖、血脂、CysC和胰岛素抵抗指数（HOMA-IR）,分析CysC与各组ABI的相关性。结果：与A组比较,C组TG[（3.6±0.7）mmol/L]、TC[（6.3±2.0）mmol/L]、LDL-C[（4.5±1.1）mmol/L]、FINS[（12.2±3.2）uU/mL]、HOMA-IR（7.0±1.4）显著性升高（P〈0.05）,HDL-C[（0.83±0.22）mmol/L]显著性下降（P〈0.05）;与A、B组比较,C组HbAlc（10.9±1.1）%、FPG[（12.9±4.1）mmol/L]、2h PG[（17.5±4.6）mmol/L]、CysC[（3.9±0.8）mg/L]、SBP显著性升高（P〈0.05）;与A组比较,B组HbAlc%、FPG、2h PG、CysC显著性升高（P〈0.05）。Pearson相关分析显示,CysC与各组ABI水平正相关,r值分别为0.794、0.887、0.902（均P〈0.05）。结论：新发T2DM患者存在不同程度的下肢动脉硬化,高血糖、高血脂、高血压是新发T2DM患者并发下肢动脉硬化的危险因素;CysC与ABI水平呈正相关,促进了下肢动脉硬化的发生发展。

Objective： To investigate the risk factors of lower limb arteriosclerosis and its correlation with Cystatin C（ CysC） in patients with new-onset type 2 diabetes mellitus（ T2DM）. Methods： A retrospective analysis was performed on 68 patients with new-onset T2 DM in our hospital between 2011 and 2014. Among them,the ankle-brachial index（ ABI） was 0.9 ~ 0.7 in 26 patients（ group A）,0.5 ~ 0.7 in 24（ group B）,and below 0.5 in l8（ group C）. We compared between groups the patient＇s height,weight,blood pressure,blood sugar,blood lipids,CysC and insulin resistance index（ HOMA-IR）. We also determine the correlation between ABI and CysC.Results： Compared with group A,group B showed significantly increased values in TG [（ 3.6± 0.7） mmol / L],TC [（ 6.3±2.0） mmol / L],LDL-C [（ 4.5±1.1） mmol / L],FINS [（ 12.2± 3.2） Uu / mL] and HOMA-IR（ 7.0±1. 4）（ P0. 05）,and reduced value in HDL-C [（ 0.83± 0.22） mmol / L]（ P 0.05）. Compared with groups A and B,group C showed significantly increased values in Hb A1c（ 10. 9 ± 1. 1） %,FPG [（ 12. 9 ± 4. 1） mmol / L],2h PG [（ 17.5 ± 4. 6） mmol / L],and CysC [（ 3. 9 ± 0. 8） mg / L]（ P 0. 05）. Compared with group A,group B showed significantly increased values in Hb A1c%,FPG,2h PG and CysC（ P 0. 05）. Compared with groups A and B,group C showed significantly higher SB（ P0.05）. Pearson correlation analysis showed that the correlation coefficients（ r value） between CysC and ABI level in each group were 0. 794,0. 887 and 0. 902,respectively（ all P0.05）. Conclusion： New-onset T2 DM patients may present with varying severity of lower limb arteriosclerosis,high blood sugar,high cholesterol,and high blood pressure,which are risk factors is for lower limb arteriosclerosis as a complication in these patients. CysC is linearly correlated with the ABI level,and may promote the occurrence and development of lower limb arteriosclerosis.