糖尿病前期颈动脉内膜中层增厚的危险因素的分析

目的探讨糖尿病前期人群发生颈动脉内膜中层增厚的危险因素。方法研究对象来源于我院就诊和体检人员,包括正常人20例,空腹血糖受损28例,糖耐量异常40例,空腹血糖受损合并糖耐量异常32例。采集患者年龄、吸烟史、BMI等,并检测血糖、胰岛素、血脂、ET-1、NO等指标和彩色多普勒超声测定颈动脉内膜中层厚度。结果①IFG、IGT、IFG+IGT三组在年龄、BMI、DBP、FBG、PBG、FINS、TG的值均高于NGT组(P<0.05),IFG+IGT在年龄上高于IFG和IGT组(P<0.05)。②IFG、IGT、IFG+IGT三组的IMT、ET-1、NO值均高于NGT组(P<0.05),IGT与IFG相比ET-1差异有统计学意义(P<0.05),IFG+IGT组与IFG组相比ET-1、NO两项指标差异有统计学意义(P<0.05)。③单因素Logistic回归分析提示,发生IGT以及IFG+IGT、年龄、性别、吸烟、BMI、收缩压、舒张压、空腹胰岛素、TC、TG、ET-1、NO都和颈动脉内膜中层增厚的发生呈正相关(P<0.05),多因素Logistic分析显示,颈动脉内膜中层增厚的独立危险因素是:年龄、PBG、TG、ET-1、和吸烟。结论糖尿病前期人群戒烟、严格控制血脂、血糖对大血管病变的预防有重要意义。

Risk factor analysis of increase of the carotid artery intima-media in prediabetes

Objective To discuss the risk factors of the thickening of the carotid artery intima-media in prediabetes.Methods The object of the study came from our patients and medical personnel,including 20 cases of normal(NGT),28 cases of impaired fasting glucose(IFG),40 cases of impaired glucose tolerance(IGT),and 32 cases of impaired fasting glucose combined impaired glucose tolerance(IFG+IGT).Patient's,ages,smoking histories and so on were collected,and blood glucose,BMI,insulin,blood lipid,ET-1 and NO were tested,along with color Doppler ultrasound used to detect the carotid intima-media thickness.Results ① Age,BMI,DBP,FBG,PBG,FINS,TG in the three groups of IFG,IGT,IFG+IGT were significantly higer than those in the group of NGT(P<0.05);age in IFG+IGT group was significantly higher than that in the groupof IFG and IGT(P<0.05).②The levels of IMT,ET-1,NO in the three groups of IFG,IGT,IFG+IGT were significantly higer than those in the group of NGT(P<0.05),the level of ET-1 in the groups of IGT and IFG had significant difference(P<0.05),and the levels of ET-1 and NO in the group of IFG,IFG+IGT had significant difference(P<0.05).③Single fator logistic regression analysis pointed out that occurrences of IGT and IFG+IGT,age,gender,smoking,BMI,SBP,DBP,fasting insulin,TG,TC,ET-1,NO were positively correlated with the thicking of the carotid intima-media(P<0.05).Mutiple fators logistic analysis showed that age,PBG,TG,ET-1 and smoking were the independent risk fators of the carotid intima-media thickness increase.Conclusion It is significant for prediabetes to give up smoking,strictly control the blood lipid,especially triglycerides and blood glucose.