新诊断2型糖尿病患者颈动脉粥样硬化发生率及相关危险因素分析

目的探讨新诊断2型糖尿病患者颈动脉粥样硬化的患病情况以及相关危险因素分析。方法选取新诊断的2型糖尿病患者321例,根据有无颈动脉粥样硬化分为颈动脉正常组（118例）和颈动脉粥样硬化组（203例）。测量身高、体重、血压,检测糖脂代谢指标以及胰岛功能,颈动脉B超测定颈动脉粥样硬化斑块。结果①新诊断的2型糖尿病患者中,合并有颈动脉粥样硬化的患者占63%,其发病平均年龄为（53.99±10.87）岁,男性患者占72.4%,女性占27.6%;合并超重/肥胖患者占59.6%,高血压患者占33.2%,脂肪肝患者占78.6%。②与无颈动脉粥样硬化的患者相比,合并颈动脉粥样硬化的新诊断T2DM患者的年龄较大,合并高血压的比例较高,收缩压、低密度脂蛋白水平以及胰岛素抵抗指数较高,差异有显著性（P〈0.05）;而两组间的BMI、DBP、FPG、PPG、FINS、PINS、HBA1C、TG、TC、HDL-C、HOMA-β无明显差异（P〉0.05）。③按糖化血红蛋白水平分层后没有发现糖化血红蛋白与颈动脉粥样硬化的相关性（P〉0.05）。④logistic分析,校正年龄、性别后,结果显示SBP是影响新诊断2型糖尿病患者颈动脉粥样硬化的独立危险因素。结论新诊断的2型糖尿病患者中大部分已存在颈动脉粥样硬化,早期发现和干预颈动脉病变将延缓动脉粥样硬化的进程,从而有利于改善糖尿病患者的预后。

Prevalence and risk factors of carotid atherosclerosis in newly diagnosed type 2 diabetes

To investigate the prevalence and risk factors of carotid atherosclerosis in newly diagnosed type 2 diabetes. Methods A total of 321 newly diagnosed type 2 diabetics patients were divided into two groups according to the results of carotid artery color ultrosonography. Height,weight, blood pressure, blood lipids and the function of pancreatic islets were detected; the plaques in carotid arteries were measured by ultrosonography. Results Among newly diagnosed patients with type 2 diabetes,the proportion of patients with carotid atherosclerosis was 63%,the average of the onset age was（53.99±10.87） years old, the proportion of male patients was 72.4%; female patients was 27.6%; the overweight/obesis patients was 59.6%, the patients with high blood pressure was 33.2%, the patients with non-alcoholic fatty liver was 78.6%. Between two groups, there were significant differences in age, systolic pressure, low-density lipoprotein cholesterol and the index of HOMA-IR. Logistic regression analysis showed systolic pressure was the independent risk factor for carotid atherosclerosis in newly diagnosed type 2 diabetes. Conclusion The prevalence of carotid atherosclerosis in newly diagnosed type 2 diabetes is high, and it is signifi- cantly associated with age, systolic pressure, low-density lipoprotein cholesterol, HOMA-IR. Earlier intervention and control- ling factors would have clinical significance for prevention and treatment of type 2 diabetes.