老年2型糖尿病与动脉粥样硬化的关系

Relationship between type-2 diabetes mellitus and artery atherosclerosis in the elderly

目的 探讨老年2型糖尿病与颈动脉粥样硬化的关系及临床意义.方法 收集151例老年糖尿病患者的资料,其中合并颈动脉粥样硬化组（糖尿病＋动脉硬化组）75例,单纯2型糖尿病组76例,采用卡方检验、t检验及Logistic回归分析,分析颈动脉粥样硬化与各因素的相关性.结果 糖尿病＋动脉硬化组与单纯糖尿病组比较,糖尿病病程[（12.2±6.0）年比（10.2±5.7）年]、高血压患病率（85%比55%）、体质量指数[（25.4±3.0）kg/m2比（23.6±3.4）kg/m2]、三酰甘油[（1.8±1.1）mmol/L比（1.4±0.8）mmol/L]、低密度脂蛋白胆固醇[（2.9±0.8）mmol/L比（2.5±0.8）mmol/L]水平均升高,高密度脂蛋白胆固醇[（1.1±0.3）mmol/L比（1.3±0.3）mmol/L,]降低,差异有统计学意义（P均＜0.05）.颈动脉斑块与低密度脂蛋白胆固醇（回归系数B=5.913,P=0.001）、高血压病史（回归系数=1.430,P=0.004）、体质量指数（回归系数B=0.172,P=0.019）密切相关,这种相关独立于性别、年龄、糖尿病史、血糖水平等而存在.结论 高血压、体质量指数、低密度脂蛋白胆固醇与2型糖尿病患者颈动脉粥样硬化存在密切的独立相关性,控制高血压、体质量指数、血脂水平有助于减少老年2型糖尿病患者动脉粥样硬化的形成,对于糖尿病的预防以及治疗具有重要的临床意义.

Objective To investigate the relationship between type 2 diabetes mellitus and carotid atherosclerosis in elderly patients and its clinical significance.Methods The data of 151 elderly patients with diabetes mellitus were collected, including 75 patients with carotid atherosclerosis （diabetes＋arteriosclerosis）, 76 patients with type 2 diabetes mellitus, using Chi-square test, t-test and Logistic regression analysis, to analyze the correlation between carotid atherosclerosis and various factors.Results Diabetes ＋ arteriosclerosis group compared with the simple diabetic group, diabetes duration, prevalence of hypertension, BMI, triglyceride and low-density lipoprotein cholesterol （LDC-C） were elevated[（12.2±6.0）years vs. （10.2±5.7）years,85% vs. 55%,（25.4±2.9）kg/m2 vs.（23.7±3.4）kg/m2,（1.8±1.1）mmol/L vs. （1.4±0.8）mmol/L, （2.9±0.8）mmol/L vs.（2.5±0.8）mmol/L], while high-density lipoprotein cholesterol[（1.1±0.3）mmol/L vs. （1.3±0.3）mmol/L] was decreased cholesterol,the difference was statistically significant. There was close correlation of carotid plaques with LDL-C （regression coefficient B=5.913, P=0.001）, history of hypertension （regression coefficient B=1.430, P=0.004） and BMI （regression coefficient B=0.172, P=0.019）,this correlation was independent of gender, age, diabetes history and blood glucose levels.Conclusions Hypertension, body mass index and LDL-C are closely correlation with to carotid atherosclerosis in T2DM. Control of hypertension, body mass index and lipid levels can help to reduce the development of atherosclerosis in elderly patients with T2DM, it has important clinical significance for the prevention and treatment of diabetes.