高血压合并糖尿病患者基于腹部CT指标的危险因素分析

Analysis of risk factors in hypertension patients with diabetes mellitus based on abdominal computed tomography features

目的:分析高血压合并糖尿病患者腹部CT的图像特征及其他相关指标,探讨高血压人群并发糖尿病的危险因素。方法:回顾性分析1 962例在东南大学附属中大医院行腹部CT平扫的患者临床资料,分为正常对照组(n=858)、高血压组(n=732)、糖尿病组(n=128)及高血压合并糖尿病组(n=244)。测量所有受检者腹部CT相关指标包括脂肪肝、胰/脾CT值、内脏脂肪(VAT)面积、皮下脂肪(SAT)面积、VAT/SAT面积值、腰大肌CT值及腹主动脉钙化评分。应用Logistic回归分析筛选高血压人群并发糖尿病的危险因素。结果:Logistic回归分析显示,脂肪肝、甘油三酯水平升高、高密度脂蛋白水平降低、高血压分级增高、腰围增大及腰大肌CT值减低是高血压人群发生糖尿病的危险因素。结论:脂肪肝、增高的高血压分级、肌肉脂肪浸润程度、腰围增大和血脂异常均会增加高血压患者糖尿病的发病率。

Objective: To analyze the image feature of abdominal CT and other related indicators,and to discuss clinical risk factors for developing diabetes mellitus in patients with hypertension. Methods: A retrospective review of 1 962 patients undergoing abdominal CT scan was performed in Zhongda Hospital Affiliated Southeast University.The patients were divided into control group( n = 858),hypertension group( n = 732),diabetes mellitus group( n = 128) and hypertension with diabetes mellitus group( n = 244). Abdominal CT parameters were evaluated,including fatty liver,CT attenuation ratio of pancreas to spleen,visceral fat tissue( VAT) area,subcutaneous fat tissue area,VAT/SAT area ratio,lumbar muscle CT attenuation and abdominal aortic calcification. The risk factors for developing diabetes mellitus in hypertension patients were analyzed by Logistic regression analysis. Results: Logistic regression analysis showed that fatty liver,increased triglyceride,decreased high density lipoprotein,high grade of hypertension,increased waist circumference,and the decreased psoas muscle CT attenuation were the risk factors for developing diabetes mellitus in hypertension patients. Conclusion: In hypertension patients,fatty liver,high grade hypertension,muscle fat infiltration,increased waist circumference and hyperlipidemia are the independent risk factors for developing diabetes mellitus.