血浆残粒脂蛋白胆固醇水平对2型糖尿病患者外周动脉疾病发生及严重程度的相关性分析

Predictive value of residual lipoprotein cholesterol in the occurrence and severity of peripheral arterial disease in patients with type 2 diabetes mellitus

[目的]探讨2型糖尿病(T2DM)患者血浆残粒脂蛋白胆固醇(RLP-C)与外周动脉疾病(PAD)的发生及严重程度的相关性。[方法]选取2022年5月—12月在河南中医药大学人民医院内分泌科及心血管内科就诊且资料完整的392例T2DM患者,根据有无PAD分为PAD组(n=203)和无PAD组(n=189),收集两组一般临床资料,比较组间RLP-C水平差异,采用单因素和多因素Logistic回归分析RLP-C与PAD之间的相关性,绘制ROC曲线分析RLP-C对PAD的预测价值。[结果]与无PAD组相比,PAD组的RLP-C水平明显升高(P<0.001);RLP-C水平与PAD的严重程度呈正相关(r=0.443,P<0.001);多因素Logistic回归分析发现,RLP-C水平升高是T2DM发生PAD的主要危险因素(P<0.001);RLP-C水平预测T2DM合并PAD的曲线下面积(AUC)为0.860(95%CI:0.824~0.896,P<0.001);预测PAD发生的最佳RLP-C水平临界值为0.67 mmol/L。[结论]RLP-C水平与T2DM患者PAD的发生及严重程度呈正相关,且是PAD发生的独立危险因素,RLP-C水平>0.67 mmol/L时T2DM患者发生PAD的风险增加。

Aim To explore the correlation between residual lipoprotein cholesterol(RLP-C)and the occurrence and severity of peripheral arterial disease(PAD)in patients with type 2 diabetes mellitus(T2DM).Methods 392 T2DM patients with complete data who attended the Department of Endocrinology and the Department of Cardiovascular Medicine of People's Hospital of Henan University of Traditional Chinese Medicine from May 2022 to December 2022 were selected and classified into PAD group(n=203)and non-PAD group(n=189).General clinical data were collected between the groups,the difference of RLP-C level was compared between the two groups,the correlation between RLP-C and PAD was examined by using univariate and multivariate Logistic regression analysis,and ROC curve was plotted to analyze the predictive value of RLP-C for PAD.Results Compared with non-PAD group,RLP-C level was significantly higher in PAD group(P<0.001);RLP-C was positively correlated with the severity of PAD(r=0.443,P<0.001);Multifactorial Logistic regression analysis revealed that RLP-C was a major risk factor for the development of PAD in T2DM(P<0.001);The area under the curve(AUC)of RLP-C level prediction for T2DM combined with PAD was 0.860(95%CI:0.824~0.896,P<0.001);The optimal RLP-C threshold for predicting the development of PAD was 0.67 mmol/L.Conclusion RLP-C level was positively associated with the occurrence and severity of PAD in patients with T2DM,and RLP-C was an independent risk factor for the development of PAD.In addition,RLP-C>0.67 mmol/L increased the risk of PAD in T2DM patients.