2型糖尿病患者慢性并发症的相关危险因素分析

Risk factors of chronic complications in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者慢性并发症的相关危险因素。方法选取2019年1至2021年8月延安大学咸阳医院血液内分泌科诊治的82例T2DM患者为研究对象,根据是否合并慢性并发症分为CC组(合并慢性并发症)51例和NCC组(不合并慢性并发症)31例。于入院24 h内,收集两组患者的一般资料,检测并比较外周静脉血三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、血白蛋白、血尿素氮(BUN)、糖化血红蛋白(HbA1c)、25-羟基维生素D3[25-(OH)D3]水平以及腰椎骨密度(BMD)、股骨颈BMD;采用单因素分析和多因素Logistic回归模型分析T2DM慢性并发症的独立危险因素。结果82例T2DM患者中,51例(62.20%)合并至少1种慢性并发症,以微血管病变和大血管病变为主;CC组患者的年龄、糖尿病病程、SBP、FPG、TC、TG、LDL-C、BUN、HbA1c及肌酐水平明显高于NCC组,血白蛋白水平明显低于NCC组,差异均有统计学意义(P<0.05);CC组患者的股骨颈BMD、腰椎BMD及血清25-(OH)D3水平明显低于NCC组,差异均有统计学意义(P<0.05);多因素Logistic回归模型分析结果显示,糖尿病病程长,高HbA1c、LDL-C、SBP水平和低25-(OH)D3水平是T2DM患者发生慢性并发症的独立危险因素(P<0.05)。结论病程长,高HbA1c、LDL-C、SBP水平以及低25-(OH)D3水平是T2DM慢性并发症的独立危险因素。

Objective To explore the related risk factors of chronic complications(CC)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 82 patients with T2DM treated in Department of Hematology and Endocrinology,Xianyang Hospital of Yan'an University between January 2019 and August 2021 were enrolled as the research objects.According to presence or absence of CC,they were divided into CC group(n=51)and NCC group(n=31).Within 24 h after admission,the general data of patients in both groups were collected.The levels of peripheral blood triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FPG),serum albumin,blood urea nitrogen(BUN),glycated hemoglobin A1c(HbA1c),25-hydroxyvitamin D3[25-(OH)D3],lumbar bone mineral density(BMD),and femoral neck BMD were detected and compared.The independent risk factors of chronic complications in T2DM were analyzed by univariate analysis and multivariate Logistic regression model.Results Among the 82 patients with T2DM,there were 51(62.20%)cases with at least one kind of chronic complication,mainly on microvascular lesions and macrovascular lesions.The age,diabetes course,SBP,FPG,TC,TG,LDL-C,BUN,HbA1c,and creatinine levels in CC group were significantly higher than those in NCC group,while the level of serum albumin was significnatly lower than that in NCC group,with statistically significant differences(P<0.05).The femoral neck BMD and lumbar BMD,serum 25-(OH)D3 levels in CC group were significantly lower than those in NCC group,with statistically significant differences(P<0.05).Multivariate logistic regression model analysis showed that long diabetes course,high levels of HbA1c,LDL-C,SBP,and low level of 25-(OH)D3 were independent risk factors of chronic complications in T2DM patients(P<0.05).Conclusion Long course of disease,high levels of HbA1c,LDL-C,and SBP,and low level of 25-(OH)D3 are independent risk factors of chronic complications in T2DM.