无临床心脑血管并发症的2型糖尿病患者动脉僵硬度变化的研究

Change on arterial stiffness in patients with type 2 diabetes mellitus without clinical cardio—and cerebrovascular complications

目的:探讨无临床心血管并发症的2型糖尿病患者大动脉僵硬度的变化。方法:选择在我院内分泌科住院治疗的2型糖尿病患者85例,均无任何临床心脑血管并发症,并根据颈动脉超声检查结果分为合并亚临床颈动脉粥样硬化组(CAS组,42例)和未合并亚临床颈动脉粥样硬化组(无CAS组,43例)。另入选同期于我院进行健康体检正常者作为健康对照组(40例)。比较各组一般资料、生化指标、颈动脉内膜中层厚度(IMT)及颈-股脉搏波传导速度(cf-PWV)。结果:与健康对照组和无CAS组比较,CAS组IMT值显著增加[(0.52±0.12) mm、(0.53±0.10) mm比(0.84±0.15) mm,P均=0.001];健康对照组、无CAS组和CAS组中患者cf-PWV值依次显著升高[(7.88±3.23)m/s比(10.82±4.37) m/s比(13.58±4.15) m/s,P均<0.01]。多元线性回归分析显示:年龄、收缩压、HOMA-IR及空腹血糖水平均是2型糖尿病患者cf-PWV的正向影响因素(β=0.155~0.411,P<0.05或<0.01)。结论:无临床心脑血管并发症的2型糖尿病患者动脉僵硬度显著增加,并且这些患者的动脉僵硬度增加较颈动脉粥样硬化发生更早。

Objective:To investigate the changes of large arterial stiffness in patients with type 2 diabetes mellitus(T2DM) without clinical cardiovascular complications.Methods:A total of 85 T2DM patients treated in our department of endocrinology without any clinical cardio-and cerebrovascular complications were selected.According to the results of carotid ultrasound examination,they were divided into subclinical carotid atherosclerosis group(CAS group,n=42) and no subclinical carotid atherosclerosis group(no CAS group,n=43).Another 40 healthy subjects undergoing physical examination in our hospital simultaneously were enrolled as healthy control group.General data,biochemical indexes,carotid intima-media thickness(IMT) and carotid-femoral pulse wave velocity(cf-PWV) were compared among all groups.Results:Compared with healthy control group and no CAS group,there was significant rise in IMT [(0.52±0.12) mm,(0.53±0.10) mm vs.(0.84±0.15) mm,P=0.001 all]in CAS group;there was significant rise in cf-PWV [(7.88±3.23)m/s vs.(10.82±4.37) m/s vs.(13.58±4.15) m/s,P0.01 all]in order of healthy control group,no CAS group and CAS group.Multivariate linear regression analysis indicated that age,SBP,HOMA-IR and FPG level were positive influencing factors for cf-PWV in T2DM patients(β=0.155~0.411,P0.05 or 0.01).Conclusion:The arterial stiffness significantly increases in patients with type 2 diabetes mellitus without clinical cardio-and cerebrovascular complications.And the increase of arterial stiffness in these patients is earlier than that of carotid atherosclerosis.