肥胖测量指标与2型糖尿病患者冠状动脉病变的关系

目的探讨腰围、腰臀比、体质量指数中哪种肥胖测量指标与2型糖尿病患者冠状动脉病变关系更密切。方法经冠状动脉造影证实确诊为冠心病并同时符合2型糖尿病诊断标准的患者104例,按冠状动脉Gensini积分值分成四组,比较血脂,血糖等基本情况。将三种指标与Gensini积分值的关系进行直线相关和回归分析。结果①与Gensini积分值最低组(<25分)相比,积分值最高组(>75分)的三酰甘油、低密度脂蛋白水平显著升高(P<0.01),空腹血糖水平高(P<0.05),高密度脂蛋白水平降低(P<0.05),腰围、腰臀比、体质量指数数值显著增加(P<0.05)。②直线相关分析表明,腰围、腰臀比与Gensini积分值均呈显著的正相关(P<0.005)。而体质量指数与Gensini积分值无显著相关性。调整年龄、血糖、血脂等因素后,多元直线回归分析显示腰臀比与Gensini积分值仍显著正相关。(标准偏回归系数=1.83,P=0.005)。结论三种肥胖测量指标中腰臀比与2型糖尿病患者冠状动脉病变关系最密切。

The Relationship between Obesity Measure of Coronary Artery Disease in Patients with Type 2 Diabetes

Objective To investigate the correlation between obese parameters [waist circumference（WC）, waist hip ratio （WHR）, body mass index （BM1）J and coronary artery diseases （CAD） in patients with type 2 diabetes meUitus （T2DM）. Methods Based on the coronary Gensini scores, 104 patients with T2DM and CAD were stratified into 4 groups, blood lipid and glucose levels were compared between groups. The correlation between obese parameters and Gensini was identified by multiple linear regression analysis. Results Compared with the Gensini score the lowest （〈25 points）, the integral value of the highest group （〉 75 points）, triglyccride, LDL levels were significantly higher （P 〈0.01）, fasting glucose levels （P 〈0.05）, lower HDL levels （P 〈0.05）, waist circumference, waist to hip ratio, body mass index values increased significantly （P 〈0.05）.（~WC and WHR was significantly correlated with Gensini scores （P 〈0.005）while there was no correlation was found between BMI and Gensini scores. With adjusting parameters of age, blood lipid and glucose, WHR was positively correlated with Gensini scores in a multiple linear regression analysis （~=i.83, P--0.005）. Conclusions There is a significant correlation between WHR and CAD in patients with T2DM.