糖代谢异常与脑白质疏松相关性初步研究

目的初步探讨糖代谢异常与脑白质疏松的相关性。方法选取196例北京天坛医院2007年1月～2009年9月神经内科住院患者,根据颅脑磁共振的结果分为脑白质疏松(Leukoaraiosis,LA)组98例及非脑白质疏松(non—Leukoraiosis,non—LA)对照组98例,收集空腹血糖(fasting plasma glucose,FPG)、口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)的2h血糖(2 hour plasma glucose,2hPG)、年龄、性别、高血压、糖化血红蛋白(HbA_1c)水平、血脂水平、血浆同型半胱氨酸(plasma homocysteine,pHCY)水平及超敏c反应蛋白(high sensiWvity C—reactiveprotein,hsC-RP)水平等各指标。结果脑白质疏松组糖代谢异常患者比例及血糖水平(FPG和OGTT 2hPG)均显著高于对照组,差异有统计学意义(P0.05)。单因素分析显示,糖代谢异常与脑白质疏松的严重程度有明显相关性(P=0.011)。多因素分析结果显示年龄、高血压、血浆同型半胱氨酸血水平与脑白质疏松关系密切比值比(odds ratio,OR)分别为1.108、2.574、1.071]。结论糖代谢异常与脑白质疏松的发生关系密切,糖代谢异常情况越重,LA程度越严重。此外,年龄、高血压和血浆同型半胱氨酸水平也是脑白质疏松的重要影响因素。

Relationship between Olycometabolism Abnormality and Leukoaraiosis

Objective To explorer the effects of hyperglycemia on leukoaraiosis. Methods We recruited 196 patients with leukoaraiosis （LA） and non-leukoaraiosis （non-LA） who were hospitalized in neurology department of Beijing Tiantan hospital between January 2007 to September 2009, the number of cases in each group were 98. Fasting plasma glucose （FPG）, glucose tolerance test （OGTT）, age, gender, blood pressure, blood fat, plasma homocysteine level （HbAtc）, high sensitivity C-reactive protein （hs-CRP） and plasma homocysteic acid （pHCY） were tested after rolled in. The informations were compared and analyzed in different groups. Results The simple factor analysis showed that the rate of patients with hyperglycemia and the level of glucose in LA group were significant higher than non-LA group and the data showed a statistical significance （P〈0.05）. There was a significantly correlated between glycometabolism abnormality and the severity of leukoaraiosis （P=-0.011）. Variable in logistic regression showed the more important risk factors were age, hypertension and the level ofpHCY （OR=l.108, 2.574, 1.071）. Conclusion The study proves that there is significantly correlation between hyperglycemia and leukoaraiosis. In the patients,the more severe of glycometabolism abnormality, the higher severity of LA can be detected.Age, hypertension, and the level of pHCY can be considered as risk factors for leukoaraiosis.