2型糖尿病相关微血管疾病与心房颤动的关系

目的 探讨2型糖尿病相关微血管疾病负担及其与心房颤动的关系。方法 选取2012年1月至2019年12月湖州市第三人民医院收治的256例2型糖尿病患者,评估患者糖尿病相关微血管疾病患病状态,以心电图检查为依据判断心房颤动事件,采用单因素、多因素分析法分析微血管疾病与心房颤动的关系。结果 微血管疾病负担较高的2型糖尿病患者年龄更大,男性更常见,体质量指数、收缩压及糖化血红蛋白更高,糖尿病病程更长,差异有统计学意义（P<0.05）。单因素分析发现,吸烟、低密度脂蛋白胆固醇（low density lipoprotein-cholesterol,LDL-C）、估算肾小球滤过率（estimated glomerular filtration rate,eGFR）、尿蛋白/肌酐、糖尿病肾病、周围神经病变及微血管疾病负担均为2型糖尿病患者发生心房颤动的影响因素（P<0.05）。多因素回归模型控制混杂因素后发现,糖尿病肾病、周围神经病变、微血管疾病负担、LDL-C、eGFR均为2型糖尿病患者发生心房颤动的独立影响因素（P<0.05）。结论 2型糖尿病患者中,微血管疾病的存在及其负担与心房颤动事件高风险独立相关。

Relationship between type 2 diabetes mellitus related microvascular diseases and atrial fibrillation

Objective To investigate the burden of microvascular disease associated with type 2 diabetes mellitus and its relationship with atrial fibrillation. Methods A total of 256 patients with type 2 diabetes mellitus treated in Huzhou Third Municipal Hospital from January 2012 to December 2019 were selected. To evaluate the prevalence of diabetes mellitus related microvascular diseases, judge the events of atrial fibrillation based on electrocardiogram, and analyze the relationship between microvascular diseases and atrial fibrillation by univariate and multivariate analysis. Results Type 2 diabetes mellitus patients with higher burden of microvascular disease were older, more common in men, higher body mass index, systolic blood pressure and glycosylated hemoglobin, and longer duration of diabetes mellitus, the difference was statistically significant (P<0.05). Univariate analysis showed that smoking, low density lipoprotein-cholesterol (LDL-C), estimated glomerular filtration rate (eGFR), urinary protein/creatinine, diabetes nephropathy, diabetic neuropathy, and the burden of microvascular disease were the influencing factors of atrial fibrillation in type 2 diabetes mellitus patients (P<0.05). After controlling for confounding factors, the multivariate regression model found that diabetes nephropathy, diabetic neuropathy, the burden of microvascular disease, LDL-C, eGFR were independent influencing factors for atrial fibrillation in type 2 diabetes mellitus patients (P<0.05). Conclusion In type 2 diabetes mellitus patients, the existence and burden of microvascular disease are independently related to the high risk of atrial fibrillation events.