2型糖尿病患者血浆致动脉粥样硬化指数相关危险因素研究

摘要

To study the patients with type 2 diabetes mellitus(T2DM)plasma atherosclerosis index (AIP)and for other risk factors for atherosclerosis(AS).Method:152 patients with T2DM with AIP value of 0.06 as the point of tangency were selected,and they were divided into send arteriosclerosis of the phenotypic group(the group N 65 cases:AIP<0.06)and the atherosclerosis phenotypic group(the group A 87 cases:AIP 0.06 or higher),the clinical and biochemical indexes between two groups were compared.Result:The body mass index(BMI),waist hip ratio,and insulin resistance(HOMA IR)and insulin secretion index(HOMA-β),triglycerides(TG),low-density lipoprotein cholesterol (LDL-C),low density lipoprotein cholesterol(VLDL-C),blood uric acid in the group A were higher than those of the group N(P<0.05 or P<0.01),high density lipoprotein cholesterol(HDL-C)less than the group N(P<0.01),the higher incidence of coronary heart disease(P<0.05). Correlation analysis showed that AIP and BMI,waist hip ratio,systolic pressure,diastolic pressure,HOMA IR,HOMA-β,TC,TG,LDL and VLDL-C,blood uric acid positive correlation (P<0.05),and negatively correlated to HDL-C(P<0.001). Logistic Regression analysis showed,HDL-C,LDL-C, VLDL-C,TG were the independent factors affected the AIP(P<0.01).Conclusion:In patients with type 2 diabetes,can indirect reactions of LDL-C particle size index AIP,with obesity and insulin resistance,hyperinsulinemia is HDL-C, VLDL-C,TG and blood uric acid and other closely related to AS risk factors,control these risk factors is beneficial to reduce the AIP,slowing the occurrence and development of AS.%目的：探讨2型糖尿病患者血浆致动脉粥样硬化指数（AIP）与其他致动脉粥样硬化（AS）危险因素的相关性。方法：152例2型糖尿病患者以AIP值0.06为切点，分为非致动脉硬化表型组（N组65例：AIP<0.06）和致动脉硬化表型组（A组87例：AIP≥0.06），比较两组间的临床生化指标。结果：A组体重指数（BMI）、腰臀比、胰岛素抵抗指数（HOMA-IR）、胰岛素分泌指数（HOMA-β）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、极低密度脂蛋白胆固醇（VLDL-C）、血尿酸均高于N组（P<0.05或P<0.01），高密度脂蛋白胆固醇（HDL-C）低于N组（P<0.01），且冠心病发病率较高（P<0.05）。相关分析表明，AIP与BMI、腰臀比、收缩压、舒张压、HOMA-IR、HOMA-β、TC、TG、LDL-C、VLDL-C、血尿酸呈正相关（P<0.05），与HDL-C负相关（P<0.01）。Logistic Regression分析结果显示，HDL-C、LDL-C、VLDL-C、TG是AIP的独立影响因素（P<0.01）。结论：2型糖尿病患者中，能间接反应LDL-C颗粒大小的指标AIP与肥胖和胰岛素抵抗、高胰岛素血症、HDL-C、VLDL-C、TG、血尿酸等其他致AS危险因素密切相关，控制这些危险因素有利于降低AIP，从而减缓AS的发生和发展。