老年人糖调节受损与左心室应变率的相关性

Association between impaired glucose regulation and left ventricular strain rate in the elderly subjects

目的探讨老年人糖调节受损与左心室应变率(SR)的相关性。方法选取2013年6月至2015年9月解放军第四五一医院226例老年受试者进行口服葡萄糖耐量试验及左心室应变率检测,根据试验结果及2007年国际糖尿病联盟血糖管理指南,将受试者分为对照组、糖调节受损组及新诊断糖尿病组。结果与对照组比较,糖调节受损组及新诊断糖尿病组心尖部、中间段及基底段的舒张早期最大应变率(SRe)及舒张晚期最大应变率(SRa)显著降低,基底段的收缩期最大应变率(SRs)显著升高,新诊断糖尿病组心尖部及中间段的SRs显著升高,差异有统计学意义(P <0. 05)。Pearson相关分析显示,2 h血糖水平与心尖部、中间段及基底段SRe(相关系数分别为-0. 320、-0. 414及-0. 306,均P <0. 001)和SRa(相关系数分别为-0. 347、-0. 457及-0. 312,均P <0. 001)呈显著负相关,与SRs(相关系数分别为0. 288、0. 385及0. 262,均P <0. 001)呈显著正相关。多元线性回归分析显示,2h血糖是影响心尖部、中间段、基底段SRe、SRa及SRs的主要因素。结论糖调节受损者已经存在心脏收缩与舒张功能的下降。

Objects To explore the association between impaired glucose regulation and left ventricular strain rate(SR)in the elderly subjects.Methods Oral glucose tolerance test(OGTT)was performed and left ventricular strain rate was assessed using echocardiography in 226 elderly subjects.According to the results of OGTT and the guide of International Diabetes Federation in 2007,all subjects were divided into three groups,namely,control group,impaired glucose regulation group and new diagnosed diabetes group.Results Peak early diastolic strain rate(SRe)and peak late diastolic strain rate(SRa)of left ventricular apex,middle section,and basic section in impaired glucose regulation group and new diagnosed diabetes group were significant lower than those in control group(P<0.05).Peak systolic strain rate(SRs)of left ventricular basic section in impaired glucose regulation group and new diagnosed diabetes group were significant higher than that in control group(P<0.05).SRs of left ventricular apex and middle section were significant higher than that in control group(P<0.05).Pearson analysis showed that 2 h glucose levels after OGTT was negatively correlated with SRe(correlation coefficient were-0.320,-0.414,and-0.306,P<0.001,respectively)and SRa(correlation coefficient were-0.347,-0.457,and-0.312,P<0.001,respectively)of left ventricular apex,middle section,and basic section.2h glucose levels after OGTT was positively correlated with SRs of left ventricular apex,middle section,and basic section(correlation coefficient were 0.288,0.385,and 0.262,P<0.001,respectively).Multiple linear regression analysis revealed that 2h glucose level was independent risk factors for SRe,SRa and SRs of left ventricular apex,middle section,and basic section.Conclusion Systolic and diastolic function of left ventricular has impaired in the elderly subjects with impaired glucose regulation.