2型糖尿病患者糖化血红蛋白水平与颈动脉内-中膜厚度的相关性

The Relationship between Carotid Intima-Media Thickness and Hba1c Control in Type 2 Diabetes Mellitus Patients

目的:分析2型糖尿病(T2DM)患者糖化血红蛋白(Hb A1c)水平与颈动脉内-中膜厚度(CIMT)的相关性。方法:选择在我院内分泌科住院的T2DM患者328名,对入组患者进行Hb A1c、血生化指标检测以及CIMT测量等。根据CIMT值分为CIMT正常组(<0.9 mm)和CIMT增厚组(>0.9 mm),并对CIMT的相关危险因素进行多因素Logistic回归分析。结果:(1)328名T2DM患者中,CIMT正常154例,CIMT增厚174例;(2)Pearson相关分析显示,总胆固醇(TC)、Hb A1c水平与IMT值呈正相关(P<0.05)。(3)单因素分析示,CIMT正常组和CIMT增厚组两组间年龄(t=4.132,P=0.041)、收缩压(t=8.456,P<0.01)、Hb A1c≥9.0%(x^2=9.912,P<0.01)、总胆固醇(t=5.549,P=0.018)、甘油三酯(t=6.592,P=0.008)、尿酸(t=9.618,P<0.01)、空腹血糖(t=4.592,P=0.037)间差异有统计学意义;(4)多因素Logistic回归分析示,年龄、Hb A1c≥9%、收缩压、总胆固醇是T2DM患者CIMT增厚的独立危险因素(P<0.05)。结论:Hb A1c与CIMT增厚明显相关;且Hb A1c≥9%是CIMT增厚的独立危险因素。

Objective： To observe the relationship between carotid intima-media thickness （CIMT） and hemoglobin Alc （HbAlc） control in type 2 diabetes mellitus （T2DM） patients. Methods： 328 cases with T2DM were selected from the endocrinology department of our hospital. All patients underwent assessment, biochemical test and CIMT measurement. According to the value of CIMT, patients were divided into normal CIMT group （〈0.9 mm） and abnormal CIMT group （〉0.9 mm）. A multi-factor Logistic regression was performed to analyze the risk factors associated with the abnormal CIMT. Results： （1） Among the 328 T2DM patients, 154 cases had normal CIMT and 174 cases had abnormal CIMT. （2） Pearson correlation analysis indicated that the cholesterol and HbAlc levels were positively correlated with CIMT （P 〈 0.05）. （3） Univariate analysis showed that the incidence of CIMT was associated with age （t=4.132, P=0.041）, systolic blood pressure （t=-8.456, P〈0.01）, HbA1c≥ 9.0% （x2=-9.912, P〈0.01）, cholesterol （t=-5.549, P=0.018）, triglyceride （t=6.592, P=0.008）, UA（t=-9.618, P〈0.01）, fasting plasma glucose （t=4.592, P=0.037）. （4） Multi-factor Logistic regression indicated that age, systolic blood pressure, cholesterol and HbA1c a 9.0% were the independent risk factors for the onset of CIMT （P 〈0.05）. Conclusions： The level of HbAlc in T2DM patients was associated with CIMT; And HbA1c≥ 9% was the independent risk factors for the increase of CIMT.