摘要
目的探讨初诊2型糖尿病(T2DM)患者颈动脉血管病变临床风险因素。方法选择清华大学附属垂杨柳医院内分泌科2014年5月至2019年1月的初诊T2DM患者403例。同时选择我院体检中心健康人群年龄匹配的139例作为健康对照组。初诊T2DM患者403例,根据颈动脉内中膜厚度(CIMT)分为2组,CIMT<1mm为无IMT增厚组(CIMT1组,n=177);CIMT≥1mm为IMT增厚组(CIMT2组,n=226),在两组中进行包括幽门螺旋杆菌(HP)、年龄等临床指标的比较。结果初诊的T2DM患者组HP感染率为31.0%,健康对照组HP感染率21.6%,两者比较差异有统计学意义(P<0.05)。初诊T2DM患者中颈动脉血管病变的患病率为10.8%,CIMT1组和CIMT2组进行方差分析比较,发现两组间年龄、收缩压(SBP)比较差异有统计学意义(P<0.05)。进一步用倾向性匹配评分对两组人群的年龄、性别和体质指数(BMI)进行1∶1比例匹配,成功匹配264例,匹配后CTMI3组132例,匹配后CTMI4组132例。对匹配后人群进行Logistic回归分析,结果显示,胰岛素抵抗指数(HOMA-IR)、幽门螺旋杆菌感染(HP+)和低密度脂蛋白胆固醇(LDL-C)与初诊2型糖尿病患者CIMT正相关,OR值分别为2.683、2.097和2.045(P<0.05),空腹C肽(C-P)与糖尿病患者CIMT负相关,OR值为0.211(P<0.05)。结论低空腹C-P水平、胰岛素抵抗、HP感染和高低密度脂蛋白胆固醇是初诊T2DM患者颈动脉内中膜增厚的独立危险因素。初诊的T2DM患者组HP感染率高于健康人群。
Objective To evaluate the correlation between clinical risk factors and carotid intima thickness in patients with newly-diagnosed Type 2 Diabetes Mellitus(T2DM).Methods 403 patients with newly-diagnosed T2DM consecutively entered the current research project between May,2014 and January,2019 in the Department of Endocrinology,while 139 healthy people were selected as the healthy control group in the Department of medical examination during the same period in ChuiYangLiu Hospital affiliated to Tsinghua University.According to carotid intima thickness(CIMT),a total of 403 patients were divided into two groups:CIMT1 group(CIMT<1mm,n=177)and CIMT2 group(CIMT≥1mm,n=226).In both group,clinical characteristics such as Helicobacter Pylori(HP)and age were compared.Results There were more highly incidence of infection of H.Pylori in T2DM group than the health control group(31.0%vs.21.6%,P<0.05).The prevalence of carotid artery disease was 10.8%in newly diagnosed T2DM patients.It was significantly different for age and Systolic Blood Pressure(SBP)between the CIMT1 group and CIMT2 group(P<0.05).Furthermore,the propensity score matching was used by age,gender and body mass index(BMI),and 264 cases were successfully matched in two groups at a ratio of 1∶1.Then 132 cases were included in CTMI3 group and 132 cases were in CTMI4 group.After matched propensity score analysis,the logistic regression analysis showed that Homeostasis model assessment of insulin resistance index(HOMA-IR),infected with H.Pylori and Low-Density-Lipoprotein-Cholesterin(LDL-C)were positively correlated with CIMT,and OR values were 2.683,2.097 and 2.045,respectively(P<0.05).Fasting C-peptide(FC-P)was negatively correlated with CIMT,and OR value was 0.211(P<0.05).Conclusion The lower level of FC-P,insulin resistance,infected with HP and high LDL-C are important independent risk factors for CIMT in patients with newly-diagnosed T2DM.There were more highly incidence of infection of H.Pylori in patients with newly-diagnosed T2DM than health people.
作者
李彬
崔丽梅
吕纳强
饶翀
LI Bin;CUI Limei;LYU Naqiang;RAO Chong(Department of Endocrinology, Chuiyangliu Hospital Affiliated to Tsinghua University,Beijing 100022,China;Department of Special Care Center,Fuwai Cardiovascular Diseases Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China)
出处
《标记免疫分析与临床》
CAS
2021年第11期1828-1831,1850,共5页
Labeled Immunoassays and Clinical Medicine
基金
北京市朝阳区科技社会发展计划项目(编号:CYSF1921)。
关键词
2型糖尿病
颈动脉内中膜厚度
幽门螺旋杆菌
风险因素
倾向性评分
Type 2 diabetes mellitus
Carotid intima thickness
Helicobacter pylori
Risk factors
Propensity score matching
