摘要
目的探讨肥胖与非肥胖2型糖尿病(T2DM)患者下肢血管病变相关危险因素。方法选取2010年6月—2011年1月在本院内分泌科住院的T2DM患者487例,根据体质指数(BMI)的不同将患者分为非肥胖组(BMI<25 kg/m2)和肥胖组(BMI≥25.0 kg/m2);然后参照下肢血管彩色多普勒超声检查结果,再将非肥胖组和肥胖组患者分别分为两组:无下肢血管病变组(A组)及合并下肢血管病变组(B组)。分别比较非肥胖组及肥胖组中A、B组患者的年龄、病程、血压、吸烟史、饮酒史、家族史等资料以及血尿酸(BUA)、血脂〔包括总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)〕、空腹血糖(FPG)、糖化血红蛋白(HbA1c)水平;并分别对非肥胖组及肥胖组下肢血管病变的相关因素进行多因素Logistic回归分析。结果 (1)非肥胖组患者中B组年龄、病程、BUA、FPG、HbA1c、BMI均高于A组,差异有统计学意义(P<0.01);且Logistic回归分析显示,非肥胖组中年龄、病程、BUA、FPG、BMI、吸烟史与糖尿病发生下肢血管病变有回归关系(P<0.05)。(2)肥胖组患者中B组年龄、病程、TC、LDL-C、BMI、收缩压均高于A组,TG水平低于A组,差异有统计学意义(P<0.05);且Logistic回归分析显示,肥胖组中性别、年龄、HDL-C、LDL-C、HbA1c、BMI、收缩压、舒张压与糖尿病发生下肢血管病变有回归关系(P≤0.05)。结论非肥胖组下肢血管病变的相关因素有年龄、病程、BUA、FPG、BMI及吸烟史,肥胖组下肢血管病变的相关因素有年龄、性别、HDL-C、LDL-C、HbA1c、BMI、收缩压、舒张压,提示在糖尿病人群中根据BMI对相应危险因素进行针对治疗,将有助于预防下肢血管病变的发生及进展。
Objective To explore the related risk factors of lower limb vascular lesions in type 2 diabetes mellitus （T2DM） patient with and without obesity. Methods A total of 487 patients with T2DM in endocrinology department of our hospi- tal between Jun 2010 and Jan 2011 were selected. According to the body mass index （BMI）, patients were divided into obesity （ BMI ≥25.0 kg/m2 ） and non - obesity group （ BMI 〈 25 kg/m2 ） . Then the obesity and non - obesity group were divided into A group （ without lower limb vascular lesions） and B group （ with the lower limbs vascular lesions） . The data of the obesity and non - obesity group included age, the duration of disease, blood pressure, smoking history, drinking history, family history and the level of blood uric acid （BUA） and blood lipid [ total cholesterol （ TC ） and fasting plasma glucose （ FPG）, triglyceride （ TG）, high - density lipoprotein cholesterol （ HDL - C）, low density lipoprotein cholesterol （ LDL - C） J, FPG, glycosylated hemoglobin （HbAIo） were analyzed retrospectively. Multivariate Logistic regression was used to analyze the related risk factors of lower limb vascular lesions in obesity and non - obesity group. Results （ 1 ） In non - obesity subjects, the age, duration ofdisease, BUA, FPG, HbA,o and BMI of B group were significantly higher than those of A group （P 〈0. O1 ）, and the Logistic regression suggested the related factors of the lower limbs vascular lesions were age, duration of disease, BUA, FPG, BMI and smoking history. （2） In obesity subjects, the age, duration of disease, TC, LDL - C, BMI and systolic blood pressure （SBP） of B group were significantly higher than those of A group （ P 〈 O. 05 ）, while the TG level of B group was significantly lower than that of A group （P 〈0. 05）, and the Logistic regression suggested the related factors were gender, age, HDL - C, LDL - C, HbAlo, BMI, SBP and diastolic blood pressure （DBP） （P〈0. 05 ） . Conclusion The related risk factors of lower limbs vascular lesions in non - obesity group include age, duration of disease, BUA, FPG, BMI and smoking history while in o- besity group include age, gender, HDL - C, LDL - C, HbAIo, BMI, SBP and DBP, which suggests that oriented - treatment for T2DM patients with different approaches according to BMI is useful to prevent the occurrence and development of lower limbs vascular lesions.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第15期1784-1788,共5页
Chinese General Practice
关键词
糖尿病
糖尿病血管病变
肥胖
体质指数
危险因素
Diabetes mellitus
Diabetic angiopathies
Obesity
Body mass index
Risk factors
