2型糖尿病合并心脏舒张功能不全相关危险因素的logistic回归分析

Logistic regression analysis of risk factors associated with type 2 diabetes mellitus combined with diastolic dysfunction

目的研究2型糖尿病病人发生心脏舒张功能不全的相关危险因素。方法选取2017年1月至2018年12月于新乡市中心医院内分泌科及心内科住院的2型糖尿病伴有心脏舒张功能不全病人120例作为病例组,随机抽取同期本院住院的2型糖尿病并且心脏舒张功能正常的病人120例作为对照组,收集两组研究对象的相关资料,并进行logistic回归分析。结果对2型糖尿病病人合并心脏舒张功能不全的相关因素进行单因素logistic回归分析发现:病人进行胰岛素治疗、二甲双胍治疗、β受体阻滞剂治疗、血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体阻滞剂(ACEI/ARB)治疗是2型糖尿病合并心脏舒张功能不全的保护因素(OR=0.192,0.187,0.188,0.162。95%CI:0.084~0.232;0.072~0.218;0.068~0.259;0.076~0.227);糖尿病肾病、脂代谢紊乱、空腹血糖、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)、D二聚体(D-D)是2型糖尿病合并心脏舒张功能不全的危险因素(OR=8.441,4.277,1.178,1.813,1.127,1.182。95%CI:3.141~13.457;1.107~5.979;0.618~2.138;1.015~2.826;0.351~1.724;0.728~2.236);多因素非条件logistic回归分析发现胰岛素治疗及二甲双胍治疗是2型糖尿病合并心脏舒张功能不全的保护因素(OR=0.198;0.181。95%CI:0.080~0.246;0.083~0.227);糖尿病肾病、HbA1c高、CRP高是2型糖尿病合并心脏舒张功能不全的危险因素(OR=8.387;6.081;6.240。95%CI:3.133~13.541;2.329~8.942;2.101~8.541)。结论胰岛素治疗、二甲双胍治疗、糖尿病肾病、HbA1c高、CRP高均与2型糖尿病合并心脏舒张功能不全有关,对于患有糖尿病肾病、HbA1c高、CRP高的2型糖尿病病人需密切关注其心脏舒张功能。

Objective To investigate the related risk factors of type 2 diabetes mellitus combined with diastolic dysfunction.Methods A hundred and twenty patients with type 2 diabetes mellitus combined with diastolic dysfunction hospitalized in Department of Endocrinology and Department of Cardiology of Xinxiang Central Hospital from January 2017 to December 2018 were selected as the case group,and another 120 diabetes patients with normal diastolic function hospitalized during the same period were randomly selected as the control group.The clinical data of the two groups were collected and analyzed by logistic regression analysis.Results Univariate logistic regression analysis showed that insulin therapy,metformin treatment,β-receptor blockers therapy and angiotensin converting enzyme inhibitor/angiotensin receptor blokckers(ACEI/ARB) therapy were protective factors of type 2 diabetes mellitus combined with diastolic dysfunction(OR=0.192,0.187,0.188,0.162,respectively;95%CI:0.084-0.232;0.072-0.218;0.068-0.259;0.076-0.227,respectively).Diabetic nephropathy,lipid metabolism disorders,fasting blood glucose,HbAlc,C-reactive protein(CRP),D-dimer(D-D) were risk factors of type 2 diabetes mellitus combined with diastolic dysfunction(OR=8.441,4.277,1.178,1.813,1.127,1.182,respectively;95%CI:3.141-13.457,1.107-5.979,0.618-2.138,1.015-2.826,0.351-1.724,0.728-2.236,respectively).Multi-factor non conditional logistic regression analysis found that insulin therapy and metformin treatment were protective factors for type 2 diabetes mellitus combined with diastolic dysfunction(OR=0.198,0.181;95% CI:0.080-0.246,0.083-0.227) and diabetic nephropathy,high HbA1 c,and high CRP were risk factors for type 2 diabetes mellitus combined with diastolic dysfunction(OR=8.387,6.081,6.240;95%CI:3.133-13.541,2.329-8.942,2.101-8.541).Conclusions Insulin therapy,metformin treatment,diabetic nephropathy,high HbAlc and high CRP are correlated with type 2 diabetes mellitus combined with diastolic dysfunction.For type 2 diabetes patients with diabetic nephropathy,high HbAlc and high CRP,diastolic function should be monitored regularly.