胰岛素抵抗对1型糖尿病患者颈动脉内膜中层厚度影响的研究

Effect of insulin resistance on carotid intima-media thickness in patients with type 1 diabetes mellitus

目的探讨IR对T1DM患者颈动脉内膜中层厚度(CIMT)的影响。方法选取2020年7月至2022年2月于中南大学湘雅二医院代谢内分泌科治疗的T1DM患者179例。采用估计葡萄糖处理率(eGDR)评估IR,按eGDR中位数进行分组,以eGDR<10.0 mg/(kg·min)定义为高IR状态。由超声科医生测量CIMT,CIMT≥0.9 mm或有斑块定义为CIMT异常。结果179例T1DM患者平均eGDR为10.0(8.9,10.7)mg/(kg·min),CIMT异常率为14.5%。CIMT异常比例与年龄和IR相关,在年龄>30岁(33.3%vs 1.0%)和高IR状态患者(20.7%vs 8.0%),CIMT异常比例高(P<0.05)。二元Logistic回归分析显示,IR是CIMT异常的危险因素。结论T1DM患者IR程度与CIMT异常密切相关;在年龄>30岁的患者中,IR是CIMT异常的危险因素。

ObjectiveTo investigate the effect of insulin resistance(IR)on carotid intima-media thickness(CIMT)in patients with type 1 diabetes mellitus(T1DM).MethodsA total of 179 patients with T1DM in the Second Xiangya Hospital,Central South University from July 2020 to February 2022were recruited.Clinical data and biochemical index were collected.The degree of IR were assessed using the estimated glucose disposal rate(eGDR).The median value,eGDR10.0 mg/(kg·min)was defined as a high IR status.CIMT was measured by the same trained and clinically experienced sonographer.CIMT≥0.9 mm or the presence of plaque was defined as abnormal CIMT.ResultsThe median eGDR of T1DM patients was 10.0(8.9,10.7)mg/(kg·min)and the abnormal CIMT rate was 14.5%.The proportion of abnormal CIMT was higher in patients aged 30 years(33.3%vs 1.0%)and in those with IR status(20.7%vs 8.0%,P<0.05).Furthermore,IR was an independent risk factor for abnormal CIMT in T1DM patients aged 30 years.ConclusionIR is strongly associated with abnormal CIMT in T1DM patients.IR is an independent risk factor for abnormal CIMT among T1DM patients over 30 years old.