2型糖尿病患者发生新型冠状病毒感染的危险因素分析

Analysis of risk factors of COVID-19 infection in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者发生新型冠状病毒感染的危险因素。方法选取未合并新型冠状病毒感染的2型糖尿病患者78例(未感染组),合并新型冠状病毒感染的2型糖尿病患者24例(感染组),比较两组的年龄、体质量指数、糖尿病病程、收缩压、舒张压、血脂、白细胞数、中性粒细胞数、空腹血糖、餐后2 h血糖、空腹C肽、餐后2 h C肽、糖化血红蛋白、β-羟丁酸,并分析上述因素与新型冠状病毒感染的相关性。结果感染组的总胆固醇显著低于未感染组,差异有统计学意义(P<0.05);感染组的糖化血红蛋白和β-羟丁酸显著高于未感染组(P<0.05)。Spearman相关分析结果显示,新型冠状病毒感染与空腹血糖、糖化血红蛋白、收缩压、β-羟丁酸成正相关(P<0.05),与总胆固醇和餐后2 h C肽成负相关(P<0.05)。Logistic回归分析结果显示,总胆固醇和糖化血红蛋白是2型糖尿病患者合并新型冠状病毒感染的重要影响因素(P<0.05)。结论空腹血糖、糖化血红蛋白、收缩压、β-羟丁酸水平升高以及总胆固醇和餐后2 h C肽水平降低可能是2型糖尿病患者发生新型冠状病毒感染的危险因素,控制相关因素可减少2型糖尿病患者感染新型冠状病毒的风险。

Objective To investigate the risk factors of corona virus disease 2019(COVID-19)infection in patients with type 2 diabetes mellitus(T2DM).Methods 78 T2DM patients without COVID-19 and 24 T2DM patients with COVID-19 were selected.Age,body mass index,duration of diabetes,systolic blood pressure,diastolic blood pressure,blood lipids,white blood cell count,neutrophil count,fasting glucose,2 h postprandial glucose,fasting C-peptide,2 h postprandial C-peptide,glycated hemoglobin,andβ-hydroxybutyrate were compared,and the correlations between the above factors and COVID-19 infection were analyzed.Results The level of total cholesterol in the infected group was significantly lower than that in the uninfected group.The difference was statistically significant(P<0.05).The levels of HbA1c andβ-hydroxybutyric acid in T2DM patients with COVID-19 were significantly higher than those in T2DM patients without COVID-19(P<0.05).Spearman correlation analysis showed that COVID-19 infection was positively correlated with fasting glucose,glycated hemoglobin,systolic blood pressure,andβ-hydroxybutyrate(P<0.05)and COVID-19 infection was negatively correlated with total cholesterol and postprandial 2 h C-peptide(P<0.05).Logistic regression analysis revealed that total cholesterol and glycated hemoglobin were important influencing factors of T2DM patients with COVID-19 infection(P<0.05).Conclusion Elevated fasting glucose,glycated hemoglobin,systolic blood pressure,andβ-hydroxybutyrate levels,as well as decreased total cholesterol and 2 h postprandial C-peptide levels,may be risk factors for the infection of COVID-19 in patients with T2DM,and control of related factors can reduce the risk of COVID-19 infection in patients with T2DM.