血清总胆红素与2型糖尿病血管并发症的相关性研究

Analysis of the correlation between serum total bilirubin and vascular complications of type 2 diabetes mellitus

目的探讨血清总胆红素(TBIL)与T2DM患者血管并发症的相关性。方法随机选取我院内分泌科住院的209例T2DM患者,按有无血管并发症分为无血管病变组(T2DM组,n=76)、微血管病变组(MV组,n=64)及微大血管病变组(M+LV组,n=69),分析各组临床资料及生化特征。结果与T2DM组比较,MV组年龄、病程、FBG、LDL-C、高敏C反应蛋白(hsC-RP)及胱抑素C(Cys-C)均升高,HDL-C及TBIL降低(P<0.05);M+LV组年龄、病程、SBP、DBP、TC、TG、LDL-C、hsC-RP及Cys-C均升高,HDL-C及TBIL降低(P<0.05);与MV组比较,M+LV组病程、TC、LDL-C、hsC-RP及Cys-C均升高,TBIL降低(P<0.05)。回归分析显示,病程[OR(95%CI)1.411(1.193,1.670),P=0.000]、HDL-C[OR(95%CI)0.038(0.004,0.390),P=0.006]、hsC-RP[OR(95%CI)4.053(2.072,7.926),P=0.000]及TBIL[OR(95%CI)0.541(0.434,0.676),P=0.000]是影响血管并发症发生的相关因素。TBIL在T2DM组、MV组及M+LV组逐渐降低[(15.69±2.66)vs(12.99±1.81)vs(9.02±2.13)mol/L,P<0.05]。结论血清TBIL可能与T2DM患者血管并发症的发生相关。

Objective To investigate the correlation between serum total bilirubin（TBIL）and vascular complications in T2DM patients. Methods 209 inpatients with T2DM were randomly divided into three groups：avascular lesion group（T2DM,n=76）and microvascular disease group（MV,n=64）,microvascular and large vascular disease group（M ＋LV,n=69）.The clinical data and biochemical characteristics of each group were analyzed. Results Compared with T2DM group,age,course of disease,FBG,LDL-C,hsC-RP and Cys-C were increased,HDL-C and TBIL were decreased in MV group（P〈0.05）.Age,course of disease,SBP,DBP,TC,TG,LDL-C,hsC-RP and Cys-C were increased,HDL-C and TBIL were decreased in M＋LV group（P〈0.05）.Compared with MV group,course of disease,TC,LDL-C,hsC-RP and Cys-C were increased and TBIL were decreased in M ＋LV group（P〈0.05）.Regression analysis showed that course of disease [OR（95%CI）1.411（1.193,1.670）,P=0.000],HDL-C[0.038（0.004,0.390）,P=0.006],hsC-RP[4.053（2.072,7.926）,P=0.000]and TBIL[0.541（0.434,0.676）,P=0.000]were related to the occurrence of vascular complications.The levels of TBIL had a decreased trend from T2DM group,MV group to M＋LV group [（15.69±2.66）vs（12.99±1.81）vs（9.02±2.13）mol/L,P〈0.05]. Conclusion TBIL may be associated with the occurrence and severity of vascular complications in T2DM patients.