摘要
目的将超敏心肌肌钙蛋白T(hs-cTnT)作为心肌损伤的检测指标,探讨在无冠心病的社区人群中血糖与hs-cTnT的相关性。方法选取1 365例无冠心病的北京部分社区人群作为研究对象,根据血糖水平及既往病史分为糖耐量正常(NGT)组、糖调节异常(IGR)组、糖尿病(DM)组。受试者均进行病史采集,体格检查,化验肝功能、肾功能、空腹血糖(FBG)、餐后2 h血糖(2 hPG)、血脂、超敏C反应蛋白(hs-CRP)、hs-cTnT等指标。结果 DM组hs-cTnT检出率(≥3 ng/L)及升高率(≥13.3 ng/L)均高于NGT组及IGR组,差异有统计学意义(P<0.05)。调整了年龄、性别、吸烟史、高血压史、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、FBG、2 hPG、肾小球滤过率(eGFR)及hs-CRP后,DM组hs-cTnT检出率[OR=1.22,95%CI(1.04,1.44),P=0.017]及升高率[OR=1.29,95%CI(1.04,1.61),P=0.021]仍高于NGT组。多因素线性逐步回归分析显示:hs-cTnT与多种心血管疾病危险因素相关,其中FBG是hs-cTnT的独立危险因素。结论在无冠心病的社区人群中,随着血糖水平的升高hs-cTnT的分布亦不同,其中hs-cTnT的检出率及升高率在DM人群中均显著升高。hs-cTnT与多项心血管事件危险因素相关,FBG是hs-cTnT的独立危险因素。
Objective To investigate the correlation between blood glucose levels and high -sensitivity cardiac tro- ponins T （hs- cTnT） in community- based population without coronary heart disease （CHD） by using hs -cTnT as measuring indicator for myocardial injury. Methods 1 365 subjects without CHD were recruited and were divided into diabetes mellitus （DM） group, impaired glucose regulation （IGR） group and normal glucose tolerance （NGT） group. The medical history, an- thropometry, laboratory measurements including total cholesterol （TC）, triglyceride （TG）, low -density lipoprotein cholester- ol （LDL- C）, high- density lipoprotein cholesterol （HDL- C）, fasting blood glucose （FBG）, 2 hours postprandial bloodglucose （2 hPG）, estimated g｜omerular filtration rate （eGFR） high - sensitivity C - reactive protein （ hs - CRP）, hs - cTnT were detected. Results Compared with NGT group and IGR group, both detectable rate （ hs - cTnT/〉 3 ng/L） and elevated rate （ hs - cTnT 1〉 lB. B ng/L） of hs - cTnT were significantly higher in DM group （P 〈 0. 05） . Even after adjusting age, sex, hypertension, current smoking, BMI, SBP, DBP, eGFR, serum levels of TG, HDL- C, LDL- C, FBG, 2 hPG and hs- CRP, the detectable rate of hs - cTnT [ OR = 1.22, 95% CI （ 1.04, 1.44）, P = 0. 017 ] and elevated rate of hs - cTnT [ OR = 1.29, 95% CI （1.04, 1.61 ）, P = 0. 021 ] were still higher in DM group compared with NGT group. Multivariable stepwise regression analysis displayed that positive correlations existed between muhiple cardiovascular risk factors and hs - cTnT, and FBG was one of the independent risk factors for hs - cTnT. Conclusion hs - cTnT has varied distributions in community - based population with different blood glucose levels. Both detectable rate and elevated rate of hs - cTnT were increased significantly in diabetic population, hs - cTnT was related to multiple risk factors of cardiovascular event. FBG was the independent risk factor for hs - cTnT elevation.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第9期974-977,共4页
Chinese General Practice
基金
北京市首都医学发展科研基金重点支持项目(2009-2038)
关键词
肌钙蛋白T
糖尿病
因素分析
统计学
Troponin T
Diabetes mellitus
Factor analysis, statistical
