首次确诊的中老年2型糖尿病患者动脉粥样硬化影响因素的相关性研究

Atherosclerosis Related Risk Factor Analysis in Middle and Old Age Patients With Newly Diagnosed Type 2 Diabetes Mellitus

目的:研究首次确诊中老年2型糖尿病患者血清胰岛素样生长因子-1(IGF-1)、胱抑素C(Cys-C)、白细胞介素(IL)-6水平与动脉粥样硬化的相关性。方法:收集来我院就诊的首次确诊2型糖尿病206例,按照彩色多普勒超声心动图检查结果无斑块或无增厚者为对照组(n=105)和有斑块或增厚者为试验组(n=101),收集一般资料及空腹血糖、餐后两小时血糖、糖化血红蛋白、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯、总胆固醇、IGF-1、Cys-C、IL-6及高敏C反应蛋白(hs-CRP)。计算体重指数(BMI)。结果:对照组颈动脉内膜中层厚度(CIMT)及血清IGF-1、hs-CRP、Cys-C、IL-6与试验组比较差异无统计学意义(P<0.05)。多元逐步回归分析结果显示CIMT与IGF-1呈负相关(r=-0.493,P<0.01),与Cys-C、IL-6及hs-CRP呈正相关(r=0.464,r=0.219,r=0.618,P<0.01)。结论:Cys-C、IL-6可能是动脉粥样硬化的独立危险因素,联合测定血清Cys-C、IL-6及IGF-1水平对预测新诊断2型糖尿病患者动脉粥样硬化可能更优。

Objective： To study the relationship between serum levels of insulin-like growth factor-1 （IGF-1）, cystation-C （Cys-C）, interleukin-6 （IL-6） and atherosclerosis in middle and old age patient with newly diagnosed type 2 diabetes mellitus （T2DM）. Methods： A total of 206 patients with newly diagnosed T2DM at the age of （67.3±10.4） years were enrolled. Based on color Doppler ultrasound examination, the patients were divided into 2 groups： Control group, the patient without carotid plaque or increased intima thickening, n=105 and Experiment group, patient with carotid plaque or increased intima thickening, n=101. The general information, fasting blood glucose, 2h postprandial blood glucose, glycosylated hemoglobin, LDL-C, HDL-C, TG, TC and IGF-1, Cys-C, IL-6, hs-CRP were recorded and compared between 2 groups, BMI was calculated in all patients. Results： Compared with Control group, Experiment group had increased carotid intima-media thickness （CIMT）, elevated serum levels of Cys-C, IL-6, hs-CRP and reduced IGF-1, allP〈0.05. Multiple Logistic regression analysis showed that CIMT was negatively related to IGF-1 （r=-0.493,P〈0.01）, positively related to Cys-C, IL-6 and hs-CRP （r=0.464,r=0.219 andr=0.618, allP〈0.01）. Conclusion： Serum levels of Cys-C and IL-6 might be the independent risk factors for atherosclerosis occurrence in meddle and old patients with T2DM; combined detection of IGF-1, Cys-C and IL-6 could help clinical diagnosis in relevant patients.