2型糖尿病患者血钙水平与颈动脉内膜中层厚度的相关性研究

Correlation between blood calcium level and carotid artery intima-media thickness in patients type 2 diabetes mellitus

目的探究2型糖尿病(T2DM)患者血钙水平与颈动脉内膜中层厚度(IMT)的相关性。方法选取2017年10月至2018年12月该院收治的T2DM患者213例作为研究对象,经彩色多普勒超声测定颈动脉IMT,分为正常组(103例)、颈动脉IMT增厚组(59例)和颈动脉粥样斑块形成组(51例)。测定各组患者血钙、血磷、空腹血糖、糖化血红蛋白、血脂、血尿酸、甲状旁腺激素、25羟维生素D等生化指标,分析血钙水平与颈动脉血管病变的相关性。结果颈动脉粥样斑块形成组患者血钙水平高于颈动脉IMT增厚组及正常组,颈动脉IMT增厚组血钙水平高于正常组,差异均有统计学意义(P<0.05)。颈动脉IMT与血钙水平呈独立正相关[偏回归系数(β)=0.715,P<0.05]。检测血钙诊断T2DM患者颈动脉病变的受试者工作特征曲线下面积为0.752,95%可信区间:0.685~0.818,最佳截断点为2.302 mmol/L,灵敏度为69.1%,特异度为76.7%,阳性预测值为76.0%,阴性预测值为69.9%。结论T2DM患者血钙水平与颈动脉IMT呈正相关,血钙水平可作为反映T2DM患者颈动脉粥样硬化严重程度的指标,血钙水平越高,患者颈动脉粥样硬化越严重。血钙水平可能是T2DM患者颈动脉粥样硬化的危险因素。

Objective To evaluate the correlation between serum calcium level and carotid artery intima-media thickness(IMT)in the patients with type 2 diabetes mellitus(T2DM).Methods A total of 213 patients with T2DM treated in this hospital from October 2017 to December 2018 were selected as the study subjects and divided into the normal group(n=103),carotid IMT thickening group(n=59)and carotid atherosclerosis plaque formation group(n=51)according to the carotid IMT detected by color Doppler ultrasonography.The biochemical indicators such as blood calcium,blood phosphorus,fasting blood glucoser,glycated hemoglobin,blood lipid,blood uric acid,parathyroid hormone and 25-hydroxyvitamin D were measured in each group.Then the correlation between blood calcium level with carotid vascular lesions was analyzed.Results The blood calcium level in the carotid atherosclerosis plaque formation group was higher than that in the carotid IMT thickening group and normal group,the blood calcium level in the carotid IMT thickening group was higher than that in the normal group,and the differences were statistically significant(P<0.05).The carotid IMT had a independently positively correlation with blood calcium level(β=0.715,P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC)of blood calcium for diagnosing T2DM was 0.752,95%confidence interval(CI):0.685-0.818,the optimal cut-off point was 2.302 mmol/L,the sensitivity was 69.1%and the specificity was 76.7%,the positive predictive value was 76.0%,and the negative predictive value was 69.9%.Conclusion In the patients with T2DM,blood calcium level is positively correlated with carotid IMT.Blood calcium level can serve as the indicator reflecting the severity degree of carotid atherosclerosis in the patients with T2DM.The higher the blood calcium level,the severer the carotid atherosclerosis is.Blood calcium level may be a risk factor for carotid atherosclerosis in the patients with T2DM.