不同性别2型糖尿病患者动脉粥样硬化指标的影响因素研究

背景　动脉粥样硬化是2型糖尿病患者常见的并发症之一，可引起严重心脑血管事件，甚至导致死亡率增加。不同性别的2型糖尿病患者动脉粥样硬化的影响因素可能不同。目的　探讨不同性别2型糖尿病患者动脉粥样硬化指标的影响因素。方法　选取2017年3月-2018年3月在海口市人民医院内分泌科和全科医学科门诊确诊的2型糖尿病患者166例，收集患者的一般资料，并测量心踝血管指数（CAVI）和踝臂指数（ABI）。结果　166例患者中，男113例，女53例。男性患者中，年龄、吸烟、低密度脂蛋白胆固醇（LDL-C）/高密度脂蛋白胆固醇（HDL-C）、糖化血红蛋白、C反应蛋白均与CAVI、ABI、运动后ABI下降百分比呈正相关（P<0.05）；收缩压、空腹血糖均与CAVI、ABI、运动后ABI下降百分比呈负相关（P<0.05）。女性患者中，年龄、LDL-C/HDL-C、糖化血红蛋白、C反应蛋白均与CAVI、ABI、运动后ABI下降百分比呈正相关（P<0.05）；收缩压、空腹血糖均与CAVI、ABI、运动后ABI下降百分比呈负相关（P<0.05）。多元线性回归分析结果显示，年龄、吸烟是男性2型糖尿病患者CAVI、ABI、运动后ABI下降百分比的影响因素（P<0.05），空腹血糖是男性2型糖尿病患者CAVI的影响因素（P<0.05）；年龄、LDL-C/HDL-C、空腹血糖是女性2型糖尿病患者CAVI、ABI、运动后ABI下降百分比的影响因素（P<0.05）。结论　年龄、吸烟是男性2型糖尿病患者动脉粥样硬化指标的影响因素；年龄、LDL-C/HDL-C、空腹血糖是女性2型糖尿病患者动脉粥样硬化指标的影响因素。

Sex-specific Risk Factors for Indicators of Atherosclerosis in Patients with Type 2 Diabetes Mellitus

Background　Atherosclerosis is one of common complications in type 2 diabetes，which can cause serious cardiovascular and cerebrovascular events，leading to increased mortality.The risk factors for atherosclerosis in type 2 diabetics may have sexual differences.Objective　To explore the sex-specific risk factors for indicators of atherosclerosis in patients with type 2 diabetes.Methods　166 outpatients with type 2 diabetes were selected from Department of Endocrinology，and Department of General Medicine，Haikou People's Hospital from March 2017 to March 2018.General data including demographics and cardio ankle vascular index（CAVI）and ankle-brachial index（ABI） and so on were collected.Results　Among the 166 patients，113 were males and 53 were females.In male patients，age，smoking，LDL-C/HDL-C ratio，glycosylated hemoglobin，and C-reactive protein were all positively correlated with CAVI，ABI，or the percentage of exercise-induced ABI decrease（P<0.05）.Systolic blood pressure and fasting blood glucose were all negatively correlated with CAVI，ABI or the percentage of exercise-induced ABI decrease（P<0.05）.In female patients，age，LDL-C/HDL-C ratio，glycosylated hemoglobin，and C-reactive protein were positively correlated with CAVI，ABI，or the percentage of exercise-induced ABI decrease（P<0.05）.Systolic blood pressure and fasting blood glucose were all negatively correlated with CAVI，ABI，or the percentage of exercise-induced ABI decrease（P<0.05）.The results of multiple linear regression analysis showed that in men，age and smoking were the influencing factors of CAVI，ABI，and the percentage of exercise-induced ABI decrease（P<0.05），and fasting blood glucose was the influencing factor of CAVI（P<0.05）.Age，fasting blood glucose，and LDL-C/HDL-C ratio were the influencing factors of CAVI，ABI，and the percentage of exercise-induced ABI decrease in women（P<0.05）.Conclusion　Atherosclerosis may appear to be associated with older age and smoking in type 2 male diabetics，and with older age，LDL-C/HDL-C ratio and elevated fasting blood glucose in type 2 female diabetics.