绝经后女性2型糖尿病合并冠心病的危险因素分析

摘要

Objective To investigate the related risk factors of type 2 diabetes mellitus (T2DM) combined with coronary heart disease (CHD) in postmenopausal women. Methods A total of 335 hospitalized postmenopausal women suffering from T2DM without CHD (non-CHD group, 157 cases) and with CHD (CHD group, 178 cases) were enrolled from Jan-uary 2012 to June 2014. Clinical data were collected and the levels of fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and blood uric acid (UA) were detected. Results Compared with the non-CHD group,the CHD group showed significantly greater age and longer duration of diabetes (P< 0.01). Further, the CHD group had higher levels of fasting blood glucose, glycosylated hemoglobin, BMI, systolic blood pressure, TC, LDL-C and TG, and lower level of HDL-C (P< 0.05 or P< 0.01). The incidences of hypertension, obesity, dyslipidemia, carotid artery plaque, cerebral stroke of CHD group were all higher than those of non-CHD group, the differences were statistically signifi-cant (P<0.05 or P<0.01). Logistic analysis showed that, age, duration of diabetes mellitus, HbA1c, LDL-C, and sys-tolic blood pressure were the independent risk factors of T2DM combined with coronary heart disease (OR=1.21, 1.11, 1.49, 1.08 and 1.03; P<0.05 or P<0.01). Conclusion Age, duration of diabetes mellitus, HbA1c, LDL-C, and systolic blood pressure are closely related to the incidence of type 2 diabetes mellitus combined with coronary heart disease in postmenopausal women.%目的：探讨绝经后女性2型糖尿病（T2DM）合并冠心病的主要相关危险因素。方法选取2012年1月~2014年6月北京市大兴区红星医院内科住院的绝经后女性2型糖尿病患者335例，其中T2DM非合并冠心病组（无冠心病组）157例，T2DM合并冠心病组（冠心病组）178例。收集两组患者的临床资料；检测空腹血糖（FPG）、糖化血红蛋白（HbA1c）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）及尿酸。结果冠心病组年龄、糖尿病病程明显高于无冠心病组（P<0.01）；与无冠心病组比较，冠心病组的FPG、HbA1c、体重指数、收缩压、TC、LDL-C及TG均升高，HDL-C降低（P<0.05或P<0.01）；冠心病组的患者高血压、肥胖、血脂紊乱、颈动脉斑块及脑卒中发病率均高于无冠心病组，差异均有统计学意义（P<0.05或P<0.01）；冠心病阳性家族史显著高于无冠心病组（P<0.01）。 Logistic回归分析结果显示，年龄、病程、HbA1c、LDL-C及收缩压是T2DM合并冠心病的独立危险因素（OR值分别为1.21、1.08、1.49、1.11和1.03，P <0.05或 P <0.01）。结论年龄、糖尿病病程、HbA1c、LDL-C及收缩压与绝经后女性2型糖尿病合并冠心病的发病密切相关。