2型糖尿病患者颈动脉内膜中层厚度与心脏舒张功能不全的相关性

Correlation of carotid intima-media thickness and cardiac diastolic dysfunction in patients with type 2 diabetes

目的探讨2型糖尿病患者(T2DM)颈动脉内膜中层厚度(CIMT)与心脏舒张功能不全的相关性。方法选取2019年1月至2020年1月在广州医科大学附属第二医院内分泌科住院治疗的381例T2DM患者。根据E/A值分为心脏舒张功能正常组(共149例)和心脏舒张功能不全组(共232例);根据CIMT值分为CIMT正常组(共213例)和CIMT增厚组(共168例),比较分析不同组别间一般情况.血脂、血糖、肝肾功能、心脏彩超及颈动脉彩超表现。Logistic多因素分析T2DM患者心脏舒张功能不全的影响因素。受试者工作特征曲线(ROC)分析CIMT值对T2DM患者心脏舒张功能不全的预测能力。结果多因素回归分析显示年龄(OR=1.067,P<0.001)、CIMT增厚(OR=1.863,P=0.011)及收缩压(OR=1.014,P=0.016)是T2DM患者心脏舒张功能不全的危险因素。受试者工作特征曲线(ROC)提示CIMT诊断T2DM患者心脏舒张功能不全的曲线下面积(AUC)为0.625(95%CI:0.568~0.683,P<0.001),最佳临界值为0.875 mm,灵敏度为52.6%,特异度为69.1%。结论CIMT增厚是T2DM患者心脏舒张功能不全的独立危险因素。CIMT水平对心脏舒张功能障碍的发生有一定的预测价值。

Objective This study explored the correlation between carotid intima-media thickness(CIMT)and cardiac diastolie dysfunction in patients with type 2 diabetes mellitus(T2DM).Methods 381 T2DM patients hospitalized in the endocrinology department of the Second Affiliated Hospital of Guangzhou Medical University from January 2019 to January 2020 were selected.According to E/A value,they were divided into normal diastolic function group(149 cases)and incomplete diastolie function group(232 cases);According to the CIMT value,they were divided into CIMT normal group(213 cases)and CIMT thickening group(168 cases).The general data,blood lipid,blood glucose,liver and kidney function,cardiac color Doppler ultrasound and carotid color Doppler ultrasound were compared and analyzed.Mulivariale logistic analysis was used to analyze the influencing factors of cardiac diastolic dysfunetion in patients with T2DM.Receiver operating characteristic curve(ROC)was used to analyze the ability of CIMT value to predict cardiac diastolic dysfunction in T2DM patients.Results Multivariate regression analysis showed that age(OR=I.067,P<0.001),increased CIMT(OR=I.863,P=0.011)and systolic blood pressure(OR=1.014,P=0.016)were the risk factors for occurrence of cardiac diastolic dysfunction in patients with T2DM(P<0.05).ROC analysis demonstrated that the area under the curve(AUC)for cardiac diastolic dysfunction diagnosed by CIMT was 0.625(95%CI:0.568-0.683,P<0.001).The cut-off value was 0.875.with a sensitivity of 52.6%and specificity of 69.1%.Conclusions Increased CIMT is an independent risk factor for eardiac diastolic dysfunction in patients with T2DM.The level of CIMT has certain predictive value for the occurrence of cardiac diastolic dysfunction.