摘要
目的探讨血清胆汁酸水平与2型糖尿病(T2DM)患者心血管事件风险的相关性。方法选取2021年1月至2022年5月攀钢集团总医院收治的T2DM患者212例,入院时测定基线血清胆汁酸水平,并根据血清胆汁酸水平中位数分为高水平组和低水平组,各106例。随访24个月,采用Kaplan-Meier模型分析两组心血管事件发生风险并采用Log-rank检验进行对比。24个月随访时高水平组99例完成随访,低水平组102例完成随访,高水平组36例发生心血管事件,低水平组9例发生心血管事件。同时根据24个月随访期间是否发生心血管事件分为发生组45例和未发生组156例,比较两组一般资料。采用COX比例风险回归模型分析T2DM患者心血管事件的影响因素,并采用限制性立方样条方法拟合血清胆汁酸水平与T2DM患者心血管事件的关系。结果Log-rank检验分析显示高水平组心血管事件发生风险高于低水平组,差异具有统计学意义(Log-rankχ^(2)=6.111,P<0.05)。发生组糖尿病病程、糖化血红蛋白(HbA1c)、低密度脂蛋白及胆汁酸水平较未发生组高,差异具有统计学意义(P<0.05)。COX比例风险回归显示,糖尿病病程、胆汁酸、HbA1c、低密度脂蛋白为T2DM患者心血管事件发生的影响因素。限制性立方样条分析显示,控制糖尿病病程、HbA1c和低密度脂蛋白后,血清胆汁酸水平与T2DM患者心血管事件呈线性剂量-反应关系(χ^(2)=28.810,P<0.05)。结论血清胆汁酸水平与T2DM患者心血管事件风险有关,可能成为预测T2DM患者发生心血管事件的标志物。
Objective To investigate the correlation between serum bile acid level and the risk of cardiovascular events in patients with type 2 diabetes mellitus(T2DM).Methods A total of 212 T2DM patients admitted to Pangang Group General Hospital from January 2021 to May 2022 were selected.Baseline serum bile acid level at admission was determined,and patients were divided into a high-level group and a low-level group according to the median serum bile acid level,with 106 cases in each group.After 24 months follow-up,the risk of cardiovascular events was analyzed using the Kaplan-Meier model and compared using the Log-rank test.At the 24-month follow-up,99 cases in the high-level group and 102 cases in the low-level group completed the follow-up.Cardiovascular events occurred in 36 cases in the high-level group and 9 cases in the low-level group.Meanwhile,based on the occurrence of cardiovascular events,the patients were divided into a occurrence group(45 cases)and a non-occurrence group(156 cases),and the general data of the two groups was compared.A COX proportional hazards regression model was used to analyze factors associated with cardiovascular events in T2DM patients,and the relationship between serum bile acid level and cardiovascular events in T2DM patients was analyzed using the restricted cubic spline.Results The Log-rank test showed that the risk of cardiovascular events was higher in the high-level group than in the low-level group(Log-Rankχ^(2)=6.111,P<0.05).The occurrence group showed significantly higher levels of diabetes duration,glycated hemoglobin(HbA1c),low-density lipoprotein(LDL),and bile acid compared to the non-occurrence group,with statistically significant differences(P<0.05).COX proportional hazards regression showed that diabetes duration,bile acid,HbA1c,and LDL were influencing factors for the occurrence of cardiovascular events.Restricted cubic spline showed a linear dose-response relationship between the serum bile acid level and the cardiovascular events in T2DM patients under the condition of controlled diabetes duration,HbA1c,and LDL(χ^(2)=28.810,P<0.05).Conclusion Serum bile acid level is associated with the risk of cardiovascular events in T2DM patients,and may be used as a marker for the prediction of cardiovascular events in T2DM patients.
作者
黄蕊
蒋化梅
张雪
Huang Rui;Jiang Huamei;Zhang Xue(Department of Endocrinology,Pangang Group General Hospital,Panzhihua 617023,China)
出处
《心脑血管病防治》
2025年第10期15-18,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
关键词
血清胆汁酸
2型糖尿病
心血管事件
Serum bile acid
Type 2 diabetes
Cardiovascular events
