初发2型糖尿病患者颈动脉内中膜厚度与各代谢指标的关系

目的探讨初发2型糖尿病（T2DM）人群中颈动脉内中膜厚度（IMT）与各代谢指标的相关关系，探寻动脉粥样硬化的危险因素。方法选择正常对照组（NC）44例、糖耐量正常的单纯肥胖组（Ob）42例、新诊的2型糖尿病患者60例，所有对象于清晨空腹测量身高、体重、腰围、臀围、血压，计算体重指数（BMI）和腰臀比（WHR）；空腹检测各组生化指标，并同时行糖耐量试验（OGTY），检测OGTT中0、30、60、120min各时点血糖及胰岛素值，利用Bergman最小模型技术计算胰岛素敏感指数（ISI）；并以高分辨率彩色血管多普勒超声检查颈总动脉（CCA）内中膜厚度。结果IMT值T2DM组较NC组（P〈0．01）及0b组显著升高（P〈0．05）。所有初发T2DM患者，IMT与年龄、甘油三酯（TC）、低密度脂蛋白（LDL—C）、餐后2h血糖（2hPG）及ISI呈正相关（P〈0．05．0．01）：与BMI、腰围呈负相关（P〈0．05）。在校正年龄、性别因素的影响后，IMT与BMI、腰围、TC、LDL-C及ISI无显著相关，与2hPG呈显著相关（r=0．461，P〈0．001）。结论2hPG是初发T2DM人群早期动脉粥样硬化（AS）的独立危险因素，降低2hPG有望改善T2DM人群的血管功能。

A Study on the Association of the Carotid Intima-Media Thickness with the Metabolic Indices in Newly Diagnosed Type-2 Diabetic Patients

Objective To explore the relationship between carotid intima-media thickness （IMT） and metabolic indices in newly diagnosed type-2 diabetic patients, and the risk factors of atherosclerosis （AS）. Methods 44 normal control subjects （NC）, 42 obese subjects with normal glucose tolerance （Ob） and 60 newly diagnosed type-2 diabetes mellitus subjects （T2DM） were recruited. Body mass index （BMI）, waist-to-hip ratio （WHR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, triglycerides （TG）, cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, fasting blood glucose （FBG） and OGTT 2-hour postpradial glucose （2-hPG） were also measured. Insulin sensitivity index （ISI） was accessed using Bergman＇s minimal model method and IMI of CCA was measured using B mode colorful Doppler ultrasonography. Results The values of CCA-IMT were increased significantly in newly diagnosed T2DM patients when compared with patients of the NC （P〈0.01） and Ob （P〈0.05） group. According to the results of logistic regression analysis, the CCA-IMT value in patients of T2DM group was positively correlated with age, TC, LDL-C, 2-hPG and ISI, but negatively associated with BMI, WHR （r= 0.311,0.264,0.285,0.447,0.325,-0.276,-0.294, all P〈0.05）. After age adjustment, only 2-hPG was positively correlated with IMT （r=0.461 ,P〈0.001 ）. Conclusion 2-hPG was found to be an independent risk factor of abnormal CCA-IMT, indicating that the control of 2-hPG will improve atherosclerosis in type-2 diabetic patients.