摘要
目的:探讨酒精摄入对男性2型糖尿病合并冠心病患者的影响。方法:选择在河北医科大学第三医院内分泌科和心内科住院的155例男性2型糖尿病合并冠心病患者,收集患者的临床资料和生化指标,明确酒精摄入量对男性2型糖尿病合并冠心病患者的影响,应用Gensini评分系统进一步评估饮酒量与冠状动脉粥样病变严重程度的关系。采用多元线性回归分析明确冠状动脉病变严重程度的危险因素。结果:男性2型糖尿病合并冠心病患者中饮酒者占63%,其中约60%饮酒者平均每日摄入酒精量超过推荐剂量。与非饮酒组患者相比,饮酒组患者体质指数[(26.1±3.6)比(24.9±3.1)kg/m^(2)]、血压[收缩压(142.0±17.6)比(131.2±17.8)mmHg(1 mmHg=0.133 kPa),舒张压(88.6±12.1)比(83.8±8.9)mmHg)]、血清总胆固醇[(4.8±1.3)比(4.3±1.3)mmol/L]、血尿酸[(370.9±89.6)比(349.6±84.3)μmol/L],以及吸烟率(76.0%比13.3%)、高血压患病率(78.6%比42.2%)均显著增高(均P<0.05)。与适量饮酒亚组相比,过量饮酒亚组低密度脂蛋白胆固醇[(3.3±0.9)比(2.8±0.9)mmol/L]、纤维蛋白原[(3.5±0.5)比(3.3±0.4)g/L]水平显著增高(P<0.05)。此外,过量饮酒亚组的吸烟率(69.0%比42.5%)及高血压患病率(93.1%比57.5%)也显著高于适量饮酒亚组。高剂量酒精摄入是男性2型糖尿病患者发生冠心病的危险因素(OR=0.259,95%CI:0.074~0.904),但不是影响冠脉病变严重程度的危险因素(t=-0.58,P=0.565)。糖化血红蛋白(t=3.11,P=0.019)、三酰甘油(t=2.30,P=0.039)及低密度脂蛋白胆固醇(t=4.24,P<0.001)是影响冠状动脉粥样硬化性病变严重程度的危险因素。结论:高剂量酒精摄入是男性2型糖尿病患者发生冠心病的危险因素,但与冠脉病变严重程度的关系仍需进一步研究。
Objective To explore the effect of alcohol consumption on the severity of coronary atherosclerotic heart disease(CHD)in male patients with type 2 diabetes mellitus(T2DM).Methods A total of 155 male T2DM patients with CHD were enrolled in the study and admitted at the Third Hospital of Hebei Medical University.Clinical and serum biochemical parameters were collected.The effect of alcohol consumption on the severity of CHD was assessed using the Gensini scoring system.Multiple linear regression was performed to analyze the risk factors of CHD in T2DM patients.Results About 63%of male T2DM patients with CHD were regular(moderate)alcohol consumers and among them,about 60%were classified as excessive drinkers.Compared to patients who did not consume alcohol,the following parameters were all significantly increased(all P<0.05):body mass index[(26.1±3.6)vs(24.9±3.1)kg/m^(2)];systolic blood pressure[(142.0±17.6)vs(131.2±17.8)mmHg(1 mmHg=0.133 kPa);diastolic blood pressure(88.6±12.1)vs(83.8±8.9)mmHg)];total cholesterol[(4.8±1.3)vs(4.3±1.3)mmol/L];uric acid[(370.9±89.6)vs(349.6±84.3)mmol/L];smoking rate(76.0%vs 13.3%);and prevalence of hypertension(76.0%vs 13.3%).Compared with patients in the moderate drinking subgroup,the level of low-density lipoprotein cholesterol[LDL-C,(3.2±0.9)vs(2.8±0.9)mmol/L]and plasma fibrinogen[(3.5±0.5)vs(3.9±0.4)mmol/L]were significantly higher(P<0.05).In addition,the smoking rate and the prevalence of hypertension in the excessive drinking subgroup were significantly higher than those in the moderate drinking subgroup(P<0.05).Excessive alcohol consumption was the risk factor(OR=0.259,95%CI:0.074-0.904,P<0.05),but not the severity factor(t=-0.58,P=0.565)for CHD in male patients with T2DM,hemoglobinA1c(t=3.11,P=0.019),triglycerides(t=2.30,P=0.039)and LDL-C(t=4.24,P<0.001)were the risk factors for the severity of CHD.Conclusions Excessive alcohol consumption may be a risk factor for CHD in male patients with T2DM,but its effect on the severity of CHD still needs further exploration.
作者
芦晶晶
王垚
张茜
刘岩
周亚茹
Lu Jingjing;Wang Yao;Zhang Xi;Liu Yan;Zhou Yaru(Department of Endocrinology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)
出处
《中华健康管理学杂志》
CAS
CSCD
2022年第3期158-163,共6页
Chinese Journal of Health Management
基金
河北省卫生健康委员会资助项目(GZ2020066)。
关键词
饮酒
2型糖尿病
冠心病
Alcohol consumption
Type 2 diabetes mellitus
Coronary heart disease