2型糖尿病患者高敏心肌肌钙蛋白相关因素分析

摘要

目的 将高敏心肌肌钙蛋白(hs-cTnT)作为预测心血管事件风险的检测指标,探讨影响2型糖尿病患者hs cTnT的相关因素.方法 2型糖尿病患者299例(糖尿病组),无2型糖尿病史的社区体检者(对照组)588例,所有受试者均进行病史采集、体格检查、化验肝功能、肾功能、空腹血糖(FBG)、餐后2小时血糖(PBG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、肾小球滤过率(eGFR)、高敏C反应蛋白(hsCRP)、hs-cTnT等项指标.结果 与对照组比较,糖尿病组高血压患病率、体质量指数(BMI)、腰围(WC)、收缩压(SBP)、LDL-C、TG、FBG、PBG、eGFR、hsCRP、hs-cTnT均高于对照组(P＜0.05),HDL-C低于对照组(P＜0.05).糖尿病组hs-cTnT浓度为5.2(7.2) ng/L,对照组hs-cTnT浓度为3.0(1.2) ng/L(P＜0.01).两组间hs-cTnT的检出率分别为65.9％,32.3％(P＜0.01),升高率分别为14.4％,4.8％(P＜0.05).直线相关分析显示,年龄(r=0.292,P＜0.01)、BMI(r =0.082,P＜0.05)、WC( r=0.154,P＜0.01)、SBP(r =0.115,P＜0.01)、FBG( r=0.225,P＜0.01)、PBG(r =0.271,P＜0.01)、hsCRP(r =0.147,P＜0.01)分别与hs-cTnT呈正相关,HDL-C(r＝-0.136,P＜0.01)、eGFR(r＝-0.119,P＜0.01)分别与hs-cTnT呈负相关.逐步回归分析显示:年龄、男性、FBG、PBG、eGFR、hsCRP是hs-cTnT的危险因素.结论 在2型糖尿病人群中,hs-cTnT的检出率及升高率均高于非2型糖尿病人群(P＜0.05),且hs cTnT与多项心血管疾病危险因素相关.%Objective High-sensitivity cardiac troponin T(hs-cTnT) was used to predict cardiovascular risk, related factors about hs-cTnT in type 2 diabetes patients were researched. Methods 299 patients with type 2 diabetes were recruited as diabetes group, 588 subjects without type 2 diabetes were recruited as control group. The disease history, physical examination, lab tests such as total cholesterol (TC) , triglyceride ( TG), low-density lipoprotein cholesterol( LDL-C), high-density lipoprotein cholesterol ( HDL-C), fasting blood glucose (FBG), postprandial blood glucose(PBG) .estimated glomerular filtration rate(Egfr) , high-sensitivity C-reactive protein ( hsCRP), hs-cTnT were measured. Results Compared with control group, the value of hypertension morbidity, body mass index(BMI) , waist circumference(WC), systolic blood pressure (SBP) , LDL-C, TG, FBG, PBG, Egfr, hsCRP, hs-cTnT were higher in diabetes group( P <0. 05) ,and HDL-C was lower( P <0. 05). The concentration of hs-cTnT was 5. 2(7. 2) ng/L in diabetes group,while that was 3. 0(1. 2) ng/L in control group( P <0. 01). The detectable rate of hs-cTnT between diabetes group and control groups was 65.9% and 32. 3% , respectively ( P <0. 01). The elevated rate of hs-cTnT between diabetes group and control groups was 14.4% and 4.8%, respectively ( P < 0. 05). Positive correlations between age( r =0.292, P <0. 01),BMI( r =0.082, P <0. 05),WC( r =0.154, P <0. 01),SBP( r =0.115, P< 0. 01),FBG( r =0.225, P <0. 01),PBG( r =0. 271, P <0. 01) ,hsCRP( r =0. 147, P <0. 01) and hs-cTnT existed, there were negative correlations between HDL-C( r = -0. 136, P <0. 01), Egfr( r =-0. 119, P <0. 01) and hs-cTnT. Results from stepwise regression analysis revealed that independent risk factors of hs-cTnT in type 2 diabetes were age,male,FBG,PBG,Egfr,hsCRP. Conclusion The findings indicated that the detectable rate and the elevated rate of hs-cTnT in diabetes group were higher than those in control group. There were correlations between hs-cTnT and multiple cardiovascular risk factors.