2型糖尿病患者合并动脉粥样硬化危险因素的分析

目的探讨2型糖尿病（T2DM）患者发生动脉粥样硬化的危险因素。方法将118例2型糖尿病患者根据病变分为2组，A组60例，伴有大血管病变；B组58例，无大血管病变。2组进行生化放免指标测定，肝脏及颈动脉内膜中层厚度（IMT）进行超声检查，分析2组患者各危险因素之间的差异。结果与B组比较，A组IMT增加更明显（1．01±0．22 vs 0．84±0.16，P〈0．05），非酒精性脂肪性肝病（NAFLD）的患病率更高（67．5％vs 47．5％，P〈0．05）；2组ALT、HbAlc、TC、LDL—C、HDL-C、BMI及HOMA-IR的均值间比较差异均有统计学意义（均P〈0．05）；TG均值2组比较差异无统计学意义（P〉0．05）。多元回归分析提示2组患者颈动脉IMT与ALT、TC、LDL-C、HOMA—IR及BMI均相关；偏相关分析提示IMT与ACT独立相关。结论脂代谢异常、胰岛素抵抗、NAFCD与T2DM患者的动脉粥样硬化的发生和发展相关。

An Analysis of Risk Factors of Atherosclerosis in Patients with T2DM

Objective To explore the risk factors of atherosclerosis in patients with type 2 diabetes mellitus （T2DM） . Methods 118 cases of patients with T2DM were divided into two groups according to disease, group A of 60 cases, with macrovascular disease ; group B of 58 cases, without macrovascular disease. The two groups had the determination of biochemical and radioimmunoassay indicators, liver and carotid artery intima-media thickness （IMT） were examed with ultrasound. The differences of the risk factors between two groups were analyzed. Results Compared with group B, IMT of group A increased more significantly（1.01 ±0.22 vs 0.84±0.16, P〈0.05）;The morbidity of nonalcoholic fatty liver disease （NAFLD） was higher（67. 5% vs 47.5% ,P〈0.05） ; There were significant differences between the mean of two groups＇ ALT, TC,LDL-C,HDL-C,BMI and HOMA-IR（P〈0.05）;There is no significant difference between the means of two groups＇ TG（P〉0.05）. Multiple regression analysis indicated that two groups＇ carotid artery IMT were related to the level of ALT, TC, LDL-C, HOMA-IR and BMI. By patial correlations analysis, carotid artery IMT was correlated with level of ALT independently. Conclusion Abnormal lipid metabolism,insulin resistance,obesity and NAFLD were related to the occurrence and development of atherosclerosis in patients with T2DM.