2型糖尿病患者颈总动脉内中膜厚度指标与握力和步速的相关性

Association of common carotid intima-media thickness with grip strength and gait speed in patients with type2diabetesmellitus

目的本研究分析了2型糖尿病(T2DM)患者超声检测的颈总动脉内中膜厚度(cIMT)及其与年龄的关系,并关联了cIMT与握力、步速之间的联系。方法来自英国生物银行(UKB)2014年的横断面数据,共纳人1036名cIMT数据完整的T2DM患者,从4个角度采集cIMT数据(右颈总动脉:120150%;左颈总动脉:210°、240°),每个测量角度产生3个指标(最大值、平均值和最小值),合计12个cIMT指标。分析其在增龄和性别间的变化趋势;评估12个cIMT指标中用于筛选颈动脉异常组(包括增厚和斑块组,cIMT1000μm)阳性率最高的单个指标;按该指标三分位分组并评估组间握力和步速及血压间的差异。结果所有12个cIMT指标均随年龄增加而增厚(P<0.001),男性T2DM患者的左侧颈总动脉的所有cIMT指标均高于女性,其中,240℃IMT的最大值、平均值和最小值在男女间的差异均随增龄而继续增加;按240℃IMT的最大值用于评估颈动脉异常组时,男女中的阳性率均高于其他11个指标,且男女间还存在显著性差异(χ^(2)=24.391,P<0.001);按左侧240℃IMT的最大值进行三分位分组,经年龄性别匹配后,发现各组间该指标增加握力和步速均下降。丝结论在T2DM患者中,cIMT随年龄增长而上升,尤其左侧240℃IMT在男性显著高于女性,且其与握力及步速下降密切相关,强调了在超声检查中关注此指标的重要性,对评估老年患者身体功能具有重要意义。

Objective This study analyzed the intima-media thickness(cIMT)indicators obtained through ultrasound examination in patients with Type 2 Diabetes Mellitus(T2DM)and their relationship with age,establishing a significant connection between cIMT and both grip strength and walking speed.Methods Cross-sectional data from the UK Biobank(UKB)2014,incorporating 1 o36 T2DM patients with complete cIMT data,was utilized.cIMT data was collected from four angles(right common carotid artery:120°,150°;left common.carotid artery:210°,240°),generating three indicators(maximum,average,and minimum values)per measurement angle,totaling 12 cIMT indicators.This included analyzing trends in age and gender;evaluating the single indicator among the 12 cIMT indicators with the highest positive rate for identifying abnormal carotid groups(including thickening and plaque groups,cIMT≥1000μm);and assessing differences in grip strength,walking speed,and blood pressure among groups divided into tertiles based on this indicator.Results All 12 cIMT indicators increased with age(P<0.001),with all indicators for the left common carotid artery in male T2DM patients being higher than those in females.Notably,the difference in the maximum,average,and minimum values of the 240°cIMT continued to increase with age between genders;the positive rates for assessing abnormal carotid groups using the maximum value of 240°cIMT were higher than the other 11 indicators in both genders,with significant differences between them(χ^(2)=24.391,P<0.001).After age and gender matching in groups divided into tertiles based on the maximum value of left 240°cIMT,a decrease in grip strength and walking speed was observed with an increase in this indicator.Conclusions In T2DM patients,cIMT increases with age,particularly the left 240°cIMT in males significantly higher than in females,and is closely related to declines in grip strength and walking speed.This emphasizes the importance of focusing on this indicator during ultrasound examinations,offering significant insights for assessing physical function in elderly patients.