2型糖尿病患者血清总胆红素水平与颈动脉内膜中层厚度的相关性分析

Correlation analysis between serum bilirubin level and carotid intima-media thickness in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者血清总胆红素水平与颈动脉内膜中层厚度(CIMT)的相关性。方法选取2018年1月至2019年12月在湖南省常德市第一人民医院住院治疗的2型糖尿病(T2DM)患者162例,根据CIMT值分为内膜增厚组(CIMT≥0.9 mm)75例和内膜正常组(CIMT<0.9 mm)87例。比较两组患者的年龄、性别、糖尿病病程、体质量指数(BMI)、血压(收缩压、舒张压)、糖化血红蛋白(HbA1c)、总胆红素(TBIL)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、空腹及餐后2 h胰岛素(FINS、2 h INS)、空腹及餐后2 h C肽(FC-P、2 h C-P)水平的差异。结果两组患者的年龄、病程、SBP、DBP、TBIL比较,差异有统计学意义(P<0.05),而性别、BMI、HbA1c、FINS、2 h INS、FC-P、2 h C-P、TG、TC、LDL-C、HDL-C水平比较,差异无统计学意义(P>0.05)。相关分析显示,CIMT与年龄、病程、SBP、DBP呈正相关(P<0.05),与TBIL呈负相关(P<0.05),CIMT与BMI、HbA1c、TC、HDL-C、LDL-C、TG、FINS、2 h INS、FC-P,2 h C-P无相关性(P>0.05)。多元逐步回归分析显示,年龄、病程、SBP、TBIL是CIMT值的独立影响因素(P<0.05)。结论T2DM患者的血清总胆红素水平与CIMT有关,是动脉粥样硬化的影响因素。

Objective To investigate the correlation between serum bilirubin level and carotid intima-media thickness(CIMT)in patients with type 2 diabetes mellitus(T2DM)in our hospital from January 2018 to December 2019.Methods A total of 162 patients with T2DM were divided into the intima-media thickness group(CIMT≥0.9 mm,n=75)and intima-media normal group(CIMT<0.9 mm,n=87)according to CIMT values.The differences in age,gender,duration of diabetes,blood pressure(systolic blood pressure,SBP,diastolic blood pressure,DBP),body mass index(BMI),glycosylated hemoglobin A1c(HbA1c),total bilirubin(TBIL),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),fasting and 2-hour postprandial insulin(FINS,2 h INS),fasting and 2-hour postprandial C-peptide(FC-P,2 h C-P)levels were compared between the two groups.Results There were significant differences in age,disease duration,SBP,DBP,and TBIL between the two groups(P<0.05).However,there was no significant difference in gender,BMI,HbA1c,FINS,2 h INS,FC-P,2 h C-P,TG,TC,LDL-C and HDL-C levels(P>0.05).Correlation analysis showed that CIMT was positively correlated with age,disease duration,SBP,and DBP(P<0.05)and negatively correlated with TBIL(P<0.05).CIMT was not correlated with BMI,HbA1c,TC,HDL-C,LDL-C,TG,FINS,2 h INS,FC-P,and 2 h C-P(P>0.05).Multiple stepwise regression analysis showed that age,disease duration,SBP,and TBIL were independent factors for CIMT values(P<0.05).Conclusion Serum bilirubin level is related to CIMT in patients with T2DM and is an influencing factor of atherosclerosis.