老年人糖代谢异常与颈动脉内-中膜厚度的相关性研究

目的探讨老年人糖代谢异常与颈动脉内-中膜厚度（IMT）的关系及影响IMT的因素。方法选择60岁以上无明确糖尿病病史但有糖尿病高危因素的老年人作为研究对象,行标准75g口服葡萄糖耐量试验（75gOGTT）,按结果分为糖耐量正常（NGT,n=44）,糖耐量减低（IGT,n=62）和糖尿病（n=45）3组,同时测定各组生化指标,采用超声检查测定颈总动脉、颈内动脉、颈外动脉内-中膜厚度（IMT）并了解血管壁情况。结果DM组及IGT组颈动脉IMT厚度较NGT组显著增加（P〈0.05）,DM组及IGT组颈动脉内膜不连续或不光滑者所占比率也较NGT组有显著升高（P〈0.05）,DM组及IGT组各颈动脉指标间差别无显著性意义（P〉0.05）。Logistic回归分析显示,年龄、CH、TG、HDL、LDL水平是IMT增厚的独立危险因素。结论与NGT组相比,IGT组存在明显的动脉粥样硬化表现,其程度与糖尿病患者接近,表明动脉粥样硬化改变早在糖耐量低减阶段就已开始。

Relationship between carotid intima-media thickness and impaired glucose metabolism

Objective To understand the relationship between carotidintima-media thickness （IMT） and impaired glucose metabolism,and explore the risk factors of atherosclerosis. Methods Objects aged over 60 years old, who had high risks for type 2 diabetes but without diabetes before, received oral glucose tolerance test （OGTT）. According to the results of OGTT, they were divided into NGT group （n=44）, IGT group （n=62）and DM group（n=45）. Some biochemical parameters were measured IMT of the common carotidartery （CCA）, internal carotidartery （ICA） and external carotidartery （ECA）, the carotid plaque, wall surface and wall texture were examined by B type ul-trasonography. Results IMTCCA increased significantly in IGT group and DM group compared with NGT group （P〈0.05）, and objects whose carotid walls were not smooth or continuous in DM group and IGT group were more than those in NGT group too （P〈0.05）. All examined glycemic parameters had no obvious difference in DM group and IGT group（P〉0.05）. According to logistic regression analysis showed that age,cholesterol,triglgceride high density lipoprotein and low density lipoprotein levels were associated with IGT. Conclusion IMTCCA increase significantly in the DM group and IGT group ,which shows that the change of atherosclerosis might have started since early IGT stage.