炎性因子在预测2型糖尿病患者合并高血压中的价值

The value of inflammatory factors in predicting hypertension in patients with type 2 diabetes mellitus

目的分析T2DM患者炎性因子水平与高血压的关系,探讨炎性因子在预测T2DM患者合并高血压中的价值。方法选取2016年3月至2017年9月于我院内分泌科和心血管内科首次住院治疗的T2DM患者240例,均≥50岁。其中合并高血压患者110例(DH组),单纯T2DM患者130例(T2DM组)。分析两组血糖、血压、炎性因子等的相关性。结果DH组糖尿病病程、FPG、HbA1c、高敏C反应蛋白(hsC⁃RP)、肿瘤坏死因子α(TNF⁃α)、白介素6(IL⁃6)、FIns及胰岛素抵抗指数均高于T2DM组。Pearson相关性分析显示,hsC⁃RP、TNF⁃α、IL⁃6与HbA1c及高血压分级呈正相关,HbA1c亦与高血压分级呈正相关(P<0.01)。Logistic回归分析显示,调整糖尿病病程和HbA1c等因素后,hsC⁃RP、TNF⁃α、IL⁃6水平升高是T2DM患者合并高血压的危险因素(P<0.05)。结论hsC⁃RP、TNF⁃α、IL⁃6升高的T2DM患者高血压发病风险更高。

Objective To analyze the relationship between hypertension and the level of inflammatory factors in patients with type 2 diabetes mellitus(T2DM),and to explore the value of inflammatory factors in predicting hypertension in patients with T2DM.Methods A total of 240 patients with T2DM were en⁃rolled in this study from Endocrinology department and Cardiovascular department in our hospital from March 2016 to September 2017.All the patients were≥50 years old,and were divided into two groups:T2DM com⁃bined with hypertension(DH group,n=110)and T2DM without hypertension(T2DM group,n=130).Blood glucose,blood pressure,and inflammatory cytokines were tested and the relationship was analyzed be⁃tween the two groups.Results The duration of T2DM,fasting plasma glucose(FPG),glycosylated he⁃moglobin A1c(HbA1c)and levels of inflammatory factoirs(hsC⁃RP,TNF⁃αand IL⁃6),fasting insulin and HOMA⁃IR were significantly higher in DH group than in T2DM group(P<0.05).Correlation analysis showed that hsC⁃RP,TNF⁃αand IL⁃6 were positively correlated with HbA1c and the hypertension grades,HbA1c was also positively correlated with the hypertension grades(P<0.01).Logistic regression analysis re⁃vealed that elevated levels of inflammatory factors(hsC⁃RP,TNF⁃α,and IL⁃6)were risk factors for hyperten⁃sion in T2DM patients after adjusting duration of diabetes and HbA1c(P<0.05).Conclusion T2DM pa⁃tients with increased inflammatory factors such as hsC⁃RP,TNF⁃αand IL⁃6 have a higher risk of hypertension.