摘要
目的评价非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇(非HDLC/HDLC)等血脂指标与2型糖尿病患者早期颈动脉斑块发生的相关性。方法回顾性分析1021例无心脑血管疾病病史的2型糖尿病患者。B超判断颈动脉斑块及测量斑块面积。比较颈动脉斑块组与无斑块组的基本资料、糖尿病病程、糖化血红蛋白、非HDLC/HDLC等血脂比值指标。分析不同血脂指标与颈动脉斑块的相关性。受试者作业特征曲线(ROC)分析非HDLC/HDLC等血脂指标对颈动脉斑块的预测价值。在斑块组,评价非HDLC/HDLC等血脂指标与斑块面积的相关性。结果斑块组男性比率、年龄、糖尿病病程、收缩压、非HDLC、非HDL/HDLC、总胆固醇(TC)/HDLC和LDLC/HDLC显著高于无斑块组,但斑块组的HDLC水平显著低于无斑块组,上述差异有统计学意义(P<0.05)。Logistc回归分析示调整混杂因素后非HDLC水平、非HDLC/HDLC、TC/HDLC和LDLC/HDLC分别是颈动脉斑块的独立危险因素(P<0.05)。LDLC水平在调整混杂因素后与颈动脉斑块无相关性。将非HDLC/HDLC与其他血脂指标的ROC曲线下面积进行比较:非HDLC/HDLC高于LDLC/HDLC、TC/HDLC,但差异接近有统计学意义(P值分别为0.052和0.058)。非HDLC/HDLC显著高于非HDLC和LDLC(P均<0.001)。在斑块组,多元回归分析显示非HDLC/HDLC和LDLC/HDLC是斑块面积的独立影响因子(P<0.05),而非HDLC和TC/HDLC在调整混杂因素后与斑块面积无相关性。结论非HDLC/HDLC是评估2型糖尿病患者早期颈动脉斑块的良好血脂指标。
Aim To evaluate the relation between non-high density lipoprotein cholesterol （non-HDLC）/HDLC and early carotid plaque in type 2 diabetes patients. Methods 1021 type 2 diabetes patients without history of cardio- vascular disease were retrospectively analyzed. Carotid plaque and plaque area were measured by B ultrasound. The general data, duration of diabetes, glycosylated hemoglobin, low density lipoprotein cholesterol （ LDLC）, HDLC, non- HDLC and the lipid ratios were compared in the group with carotid plaques and without plaques. The relation between se- rum lipid parameters and carotid artery plaque was analysed. The prediction power of the lipid parameters on carotid ar- tery plaque were analysed by receiver operating characteristic curve （ ROC ）. In the group with carotid plaques, the cor- relation of the lipid parameters and plaque area were anayzed. Results The male ratio, age, duration of diabetes, systolic blood pressure, non-HDLC levels, non-HDL/HDLC, total cholesterol（TC）/HDLC and LDLC/HDLC were signifi- cantly higher in the group with paques than the group without plaques. However, the HDLC level was significantly lower in the group with plaques than the group without plaques. The difference of the above was statistically significant （ P 〈 0. 05）. Logistc regression analysis showed that non-HDLC levels, non-HDLC/HDLC, TC/HDLC and LDLC/HDLC were independent risk factors for carotid plaque （P 〈 0. 05）. There were no correlation between LDLC levels and carotid plaques after adjustment for confounding factors. The area under ROC curve of non-HDLC/HDLC and other lipid parameters were compared： non-HDLC/HDLC was higher than that of LDLC/HDLC, TC/HDLC, but the difference was close to statis- tical significance （P = 0. 052 and 0. 058）. Non-HDLC/HDLC was significantly higher than that of HDLC and LDLC （P 〈 0. 001 ）. In the group with plaques, muhiple regression analysis showed non-HDLC/HDLC and LDLC/HDLC were the independent impact factors （P 〈 0. 05） for plaque a
出处
《中国动脉硬化杂志》
CAS
CSCD
北大核心
2013年第8期716-720,共5页
Chinese Journal of Arteriosclerosis
基金
国家自然科学青年基金(81100587)
关键词
非高密度脂蛋白胆固醇
高密度脂蛋白胆固醇
糖尿病
颈动脉斑块
Non-high Density Lipoprotein Cholesterol/High Density Lipoprotein Cholesterol
Diabetes
CarotidPlaque
