糖耐量异常与颈动脉血管壁弹性的关系及相关因素分析

Relationship between impaired glucose tolerance and carotid artery wall elasticity and its related factors analysis

目的探讨糖耐量异常与颈动脉血管壁弹性的关系及其相关因素。方法选取2014年1—12月在我院体检中心筛查的血管病变患者150例为研究对象,根据葡萄糖耐量试验结果等分为糖耐量正常组(NGT组)和糖耐量异常组(IGT组),均行颈动脉超声检查,并对两组患者的压力应变弹性系数(Ep)、动脉顺应性(AC)、僵硬度(β)及血脂、胰岛素、血糖水平进行检测。结果 IGT组β值、Ep值显著高于NGT组,AC值显著低于NGT组,差异有统计学意义(P <0. 05);IGT组空腹血糖(FPG)、餐后2 h血糖(2hPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)及胰岛素抵抗指数(HOMA-IR)水平显著高于NGT组,高密度脂蛋白(HDL-C)显著低于NGT组,差异有统计学意义(P <0. 05)。相关因素分析显示,颈动脉僵硬度β值与FPG,2hPG,TG,TC,LDL-C,HOMA-IR呈明显正相关(P <0. 05)。结论糖耐量异常患者颈动脉弹性指标改变,且在异常阶段早期动脉硬化已开始改变,与FPG,TG,TC,HOMA-IR,LDL-C及2hPG水平呈明显正相关,可作为临床筛查的重要指标。

Objective To explore the between impaired glucose tolerance and carotid artery wall elasticity and its related factors. Methods To tested the elasticity coefficient of pressure strain （Ep）, arterial compliance（ AC）, stiffness index （β） and blood lipid, insulin and blood glucose, 150 cases of patients with vascular diseases who were screened in our physical examination center from January to December 2014 were observed, and were divided into normal glucose tolerance group （the NGT group） and impaired glucose tolerance group （the IGT group） based on the glucose tolerance test results, who had adopted the carotid ultrasound examination. Results The β value and Ep value of the IGT group was remarkably higher than that of the NGT group, AC value was greatly lower than that of the NGT group, and the difference was statistically significant （ P 〈 0.05 ）. The levels of fasting plasma glucose （FPG）, 2h postprandial glucose （2hPG）, total cholesterol （TC）, triglyceride （TG）, low- density lipoprotein cholesterol （LDL- C） and homeostasis model assessment- insulin resistance index （HOMA- IR） in the IGT group was remarkably higher than those in the NGT group, high density lipoprotein cholesterol （HDL- C） was greatly lower than that in the NGT group, and the difference was statistically significant（ P 〈 0.05 ）. Correlation factor analysis showed that carotid artery stiffness β was positively correlated with FPG, 2hPG ,TG,TC, LDL - C and HOMA - IR（P 〈 0.05）. Conclusion Carotid artery elasticity changed in IGT patients, early arteriosclerosis had begun to change in abnormal phase, which was positively correlated with the levels of FPG, TG, TC, HOMA - IR, LDL - C and 2hPG, and could be used as an important index for clinical screening.