摘要
目的探讨高三酰甘油(TG)血症-腰围(WC)表型(HTGW)与2型糖尿病患者下肢动脉病变的关系。方法选取2013年5月—2014年7月在中国医科大学附属第一医院内分泌与代谢病科住院的2型糖尿病患者404例,根据是否具有高TG、高WC分为4组:TG和WC正常组(A组,n=65)、单纯高TG组(B组,n=19)、单纯高WC组(C组,n=103)和HTGW组(D组,n=217),比较4组患者的一般情况及下肢动脉病变发生率,同时分析下肢动脉病变的独立危险因素,最后应用受试者工作特征(ROC)曲线分析HTGW、WC、腰臀比(WHR)、BMI分别对男、女患者下肢动脉病变的预测价值。结果 D组WC、WHR、BMI、空腹C肽(F-C肽)水平均高于A、B、C组,总胆固醇(TC)、血尿酸(UA)、空腹胰岛素(FINS)、餐后2 h C肽(2 h-C肽)、TG水平均高于A、C组,低密度脂蛋白胆固醇(LDL-C)水平高于A组,差异有统计学意义(P<0.05);而4组餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、餐后2 h胰岛素(2 h INS)、高密度脂蛋白胆固醇(HDL-C)水平间差异无统计学意义(P>0.05)。D组下肢动脉病变发生率均高于A、B、C组,差异有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,性别、年龄、HTGW是2型糖尿病患者下肢动脉病变的影响因素(P<0.05)。HTGW预测男、女患者下肢动脉病变的ROC曲线下面积均最大,分别为0.643、0.706(P<0.05);WC、WHR预测女性患者下肢动脉病变的ROC曲线下面积分别为0.647、0.612(P<0.05),而BMI对男、女患者下肢动脉病变的诊断均无统计学意义(P>0.05)。结论 HTGW与2型糖尿病患者下肢动脉病变有关,为下肢动脉病变的独立危险因素,可作为预测2型糖尿病患者合并下肢动脉病变的良好指标。
Objective To investigate the correlation between hypertriglyceridemic-waist phenotype（ HTGW） and lower extremity arterial diseases in patients with type 2 diabetes mellitus（ T2DM）. Methods From May 2013 to July 2014,we enrolled 404 T2 DM patients who were admitted into the Department of Endocrine and Metabolism of the First Affiliated Hospital of China Medical University. According to the condition of high TG level and high WC level, the subjects were divided into 4groups： TG and WC normal group（ group A,n = 65）,pure high TG group（ group B,n = 19）,pure high WC group（ group C,n = 103） and HTGW group（ group D, n = 217）. Comparison was made among the 4 groups in general data and the incidence rate of lower extremity arterial diseases. Independent risk factors for lower extremity arterial diseases were analyzed,and ROC curves were applied to analyze the value of HTGW,WC,WHR and BMI in the diagnosis of lower extremity arterial diseases in male and female patients. Results Group D was higher than group A,group B and group C in the levels of WC,WHR,BMI and Fasting plasma C-peptid,higher than group A and group C in the levels of TC,UA,FINS,2 h C-peptid,and TG,and higher than group A in the level of LDL-C（ P 〈0. 05）; the 4 groups were not significantly different in the levels of 2 h PG,Hb A1 c,SBP,DBP,FPG,2 h INS and HDL-C（ P 〉0. 05）. Group D was higher than group A,group B and group C in the incidence rate of lower extremity arterial diseases（ P 〈0. 05）. Multivariate logistic regression analysis showed that age,gender and HTGW were influencing factors for lower extremity arterial diseases in T2 DM patients（ P 〈0. 05）. AUC values of HTGW predicting lower extremity arterial diseases in male and female patients were highest,which were 0. 643 and 0. 706 respectively（ P 〈0. 05）; the AUC values of WC and WHR predicting lower extremity arterial diseases in female patients were 0. 647 and0. 612 respectively（ P 〈0. 05）,while no statistical significance was found in BMI
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第4期422-426,共5页
Chinese General Practice
基金
辽宁省科学技术厅项目(L2011225020)--脂肪组织内质网应激介导胰岛素抵抗的分子机制及二甲双胍的干预作用
沈阳市科学技术项目(F11-264-1-50)--二甲双胍对胰岛素抵抗大鼠脂肪组织内质网应激干预作用的研究
关键词
2型糖尿病
高三酰甘油血症-腰围表型
下肢动脉病变
Diabetes mellitus
type 2
Hypertriglyceridemic-waist phenotype
Lower extremity arterial diseases
