社区居民2型糖尿病与桡动脉反射波增强指数的关系研究

The relationship between type 2 diabetes mellitus and radial artery augmentation index in a cross-sectional survey of community residents

目的探讨2型糖尿病与桡动脉反射波增强指数的关系,为预防动脉粥样硬化性心脑血管疾病(ASCVD)的发生提供依据。方法于2012年采用横断面研究设计,对北京市首钢社区居民进行问卷调查、体格检查、血糖及血脂等生化指标检测,并进行桡动脉反射波增强指数(rAI)检查,通过数学转换获得心率为75次/min时的桡动脉反射波增强指数标准校正值(rAI_(P75))。分析在无ASCVD证据的调查对象中2型糖尿病与rAI_(P75)之间的关系。结果共纳入6 946例研究对象,平均年龄为(55.90±8.63)岁,其中2 475例(35.63%)为男性,2型糖尿病患者1 550例(22.32%)。rAI_(P75)的±s为(80.29±11.90)%。相对于非糖尿病人群[(80.25±11.92)%],2型糖尿病人群具有高的rAI_(P75)水平[(80.46±11.84)%],但差异不具有统计学意义(β=0.214 0,P=0.532 7)。在对年龄、性别、体质指数(BMI)、教育程度、吸烟、饮酒、体育锻炼情况、高血压、高脂血症因素进行控制后,2型糖尿病患者rAI_(P75)升高显著(2型糖尿病患者与非糖尿病患者比较:β=0.757 6,P=0.018 7)。在亚组分析中,在男性、年轻组、无高血压组和现在不吸烟组中得到类似的结果。结论本次调查的无ASCVD证据的社区居民中2型糖尿病与rAI存在相关关系,2型糖尿病组的rAI水平显著升高,且主要体现在男性及低危(年龄小于55岁、无高血压、不吸烟)人群中。这提示在男性及低危的2型糖尿病患者中更应定期监测rAI,关注ASCVD的进展。

Objective To investigate the relationship between type 2 diabetes mellitus（T2DM） and radial artery augmentation index. Methods A community-based cross-sectional study was conducted in Beijing, China. All subjects completed a standardized questionnaire, and anthropometric data, laboratory examination data were collected. Radial artery augmentation index（rAI） was obtained non-invasively by automated applanation tonometry（HEM-9000 AI, Omron healthcare） and then adjusted for a heart rate of 75 beats per minute（rAIP75）, which was used for analyses. The correlation between T2 DM without arteriosclerotic cardiovascular disease（ASCVD） and rAIP75 was analyzed. Results A total of 6 946 subjects were enrolled. The subjects were（55.90 ±8.63） years old, 35.63% were male, and 22.32% had T2 DM. Mean AIP75were（80.29±11.90）%. Compared with non-diabetes subjects, patients with T2 DM had no significantly higher rAIP75（80.46±11.84% vs. 80.25 ±11.84%, β=0.2140, P =0.532 7）. After adjustment for age, sex, BMI, education level, current smoking, current drinking, exercise, hypertension and hyperlipidemia, multivariate linear regression analyses revealed an independent and positive relationship between T2 DM and rAIP75（β=0.757 6, P=0.018 7）. Furthermore T2 DM was an independent risk factor of rAIP75 in subgroups of male, the youth,non-hypertension and non-smoking. Conclusion T2 DM without ASCVD is significantly associated with rAIP75. T2 DM patients has significantly higher rAIP75 level, particularly in male and lower risk population. It indicates that T2 DM patients particularly in male and lower risk population should be regularly monitored for rAI to prevent ASCVD.