摘要
目的 探讨影响 2型糖尿病患者心血管危险因素集簇现象的因素。方法 分析了 6 4 1例 2型糖尿病住院患者和 5 9例健康体检者体重参数、血压、血脂、血糖、外周白细胞计数 (WBC)水平 ,采用稳态模式 (HOMA)评价胰岛素抵抗 ,并根据HOMA IR中位数 (3.2 2 98)和WBC中位数 (5 .9× 10 9/L) ,将 2型糖尿病患者分为升高组和正常组。根据心血管危险因素数量、性别、危险因素成分 ,进行分析。结果 合并 1种危险因素组 (M 1)、2种危险因素组 (M2 )、3种危险因素组 (M3)和 3种以上危险因素组 (M 4 )的体重指数 (BMI)、收缩压 (SBP)、舒张压 (DBP)、空腹血糖 (FBG)、甘油三酯 (TG)和HOMA IR水平高于无危险因素组 (M0 ) (P <0 .0 5 )。随着危险因素数量增多 ,BMI、SBP、DBP、TG、HOMA IR和胆固醇 (TC)呈升高趋势 ,高密度脂蛋白 胆固醇 (HDL C)呈降低趋势 ,各种大血管病变的患病率明显上升。合并高血压或WBC升高的 2型糖尿病患者冠心病患病率明显高于正常组 (P <0 .0 5 )。累加Logistic回归分析显示 ,SBP、BMI、FBG、HDL C、TC、TG、空腹胰岛素 (FINS)、低密度脂蛋白 胆固醇 (LDL C)、尿白蛋白排泄率 (UAER)和HOMA IR是影响男性 2型糖尿病患者心血管危险因素集簇主要的危险因素 ,SBP、BMI、TG、HDL C和UAER是影响女?
Purpose: To investigate the factors affecting the clustering of cardiovascular risk factors in Type 2 Diabetes. Methods: Six hundred and forty-one in -patient type 2 diabetes mellitus (T2DM) and fifty-nine checkup subjects were analyzed for the anthropometrical parameters, blood pressure (BP), serum lipids, serum glucose and white blood cell count (WBC). Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance. The patients of type 2 diabetes were divided into elevated and normal group according to median of HOMA-IR (3.2298) and WBC(5.9 × 109/L). Results were analyzed according to patient groups stratified by the number of cardiovascular risk factors, sex and component of the risk factors. Results: The result showed that the levels of BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), afsting blood glucose (FBG), serum triglyceride (TG) and HOMA-IR were significantly elevated in patients with one risk factor (M1), two risk factors (M2), three risk factors (M3) and clustering more than three risk factors compared with no risk factor subjects (M0) (P < 0.05). The levels of BMI, SBP, DBP, TG, HOMA-IR and serum cholesterol (TC) were increased and high density lipoprotein-cholesterol (HDL-C) was decreased step by step accompany by the number of cardiovascular risk factors increased. The prevalence of coronary heart disease in type 2 diabetic patients with hypertension or elevated WBC was higher than normal group (P < 0.05). Cumulative Logistic regression analysis showed that the risk factors of SBP, BMI, FBG, HDL-C, TC, TG, FINS, LDL-C, UAER and HOMA-IR in male and SBP, BMI, TG, HDL-C and UAER in female affected clustering of cardiovascular risk factors in T2DM. Conclusions: The clustering of cardiovascular risk factors is a common phenomenon in T2DM. It may be important for decreasing clustering of cardiovascular risk factor and incident cardiovascular disease to early intervene risk factor component.
出处
《复旦学报（医学版）》
EI
CAS
CSCD
北大核心
2004年第2期171-175,共5页
Fudan University Journal of Medical Sciences
