摘要
目的探讨不同糖代谢状态与早期动脉粥样硬化(AS)诊断指标——颈股脉搏波速度(cf-PWV)和颈动脉内膜中层厚度(IMT)之间的关系,并进一步研究其影响因素。方法 141例研究对象被分为5组:正常糖耐量组(NGT)、空腹血糖异常组(IFG)、糖耐量异常组(IGT)、IFG+IGT组和初发糖尿病组(PDM),比较各组一般临床资料、各项生化指标、cf-PWV、IMT、空腹胰岛素(FINS)、胰岛素抵抗指数(IRI)。结果 IFG、IGT、IFG+IGT和PDM各组研究对象的cf-PWV和IMT较NGT组均有显著升高(Ρ<0.01),IGT组和PDM组的cf-PWV高于IFG组(Ρ<0.05),IGT、IFG+IGT和PDM3组间的cf-PWV值差异无统计学意义,IFG、IGT、IFG+IGT3组的IMT值逐渐增加,但3组间两两比较差异无统计学意义。多元逐步回归分析显示:年龄、OGTT2h血糖、收缩压、总胆固醇是cf-PWV的独立危险因素;年龄、空腹血糖、FINS、IRI是IMT独立危险因素。结论糖耐量异常人群(包括IFG、IGT、IFG+IGT、PDM)cf-PWV和IMT显著增加,表明AS在糖尿病前期就已经开始。
ObjectiveTo investigate the relationship between different glucose metabolism status and early diagnosis indexes of atherosclerosis（AS）——carotid-femoral pulse wave velocity （cf-PWV） and carotid artery intima-media thickness （IMT）, and to further explore their influencing factors. Methods141 subjects were divided into five groups： normal glucose tolerance group （NGT, n=22）, impaired fasting glucose group （IFG, n=26）, impaired glucose tolerance group （IGT, n=35）, IFG ＋IGT group （n=26） and newly diagnosed type 2 diabetes mellitus group （PDM, n=32）. General clinical data of subjects in each group were collected, and biochemical parameters were measured. Carotid IMT was measured using Philips iU22 mode colorful Doppler ultrasonography, and cf-PWV was measured using the Complior SP （pulse wave velocity determinator）. The fasting insulin （FINS） was measured by chemoluminescence technique, and insulin resistance index（IRI） was calculated using homeostasis model assessment. ResultsBoth cf-PWV and IMT values increased significantly in IFG, IGT, IFG＋IGT and PDM group as compared with NGT group （P〈0.01）. The cf-PWV value increased in IGT and PDM group as compared with IFG group （Ρ〈0.05）, and there was no difference among IGT, IFG＋IGT and PDM group. With the worsening of abnormal glucose metabolism, from IFG, IGT to IFG＋IGT, the IMT values increased gradually, but there was no difference among the three groups. According to multivariate stepwise regression analysis, age, OGTT2h plasma glucose, systolic blood pressure and total cholesterol were found to be independent risk factors of cf-PWV, and age, fasting plasma glucose, FINS and IRI were independent risk factors of IMT. ConclusionThe cf-PWV and IMT increased significantly in IFG, IGT, IFG＋IGT and PDM group, which showed that the change of atherosclerosis might have started since early prediabetes stage.
出处
《医学研究杂志》
2010年第4期66-69,共4页
Journal of Medical Research
关键词
糖耐量异常
颈股脉搏波速度
颈动脉内膜中层厚度
动脉粥样硬化
Impaired glucose metabolism
Carotid - femoral pulse wave velocity
Carotid intima - media thickness
Atherosclerosis
