【摘要】 目的探讨初发2型糖尿病(T2DM)人群中颈动脉内中膜厚度(IMT)与各代谢指标的相关关系,探寻动脉粥样硬化的危险因素。方法选择正常对照组(NC)44例、糖耐量正常的单纯肥胖组(Ob)42例、新诊的2型糖尿病患者60例,所有对象于清晨空腹测量身高、体重、腰围、臀围、血压,计算体重指数(BMI)和腰臀比(WHR);空腹检测各组生化指标,并同时行糖耐量试验(OGTT),检测OGTT中0、30、60、120min各时点血糖及胰岛素值,利用Bergman最小模型技术计算胰岛素敏感指数(ISI);并以高分辨率彩色血管多普勒超声检查颈总动脉(CCA)内中膜厚度。结果IMT值T2DM组较NC组(P<0.01)及Ob组显著升高(P<0.05)。所有初发T2DM患者,IMT与年龄、甘油三酯(TC)、低密度脂蛋白(LDL-C)、餐后2h血糖(2hPG)及ISI呈正相关(P<0.05～0.01);与BMI、腰围呈负相关(P<0.05)。在校正年龄、性别因素的影响后,IMT与BMI、腰围、TC、LDL-C及ISI无显著相关,与2hPG呈显著相关(r=0.461,P<0.001)。结论2hPG是初发T2DM人群早期动脉粥样硬化(AS)的独立危险因素,降低2hPG有望改善T2DM人群的血管功能。更多还原

【Abstract】 Objective To explore the relationship between carotid intima-media thickness(IMT) and metabolic indices in newly diagnosed type-2 diabetic patients,and the risk factors of atherosclerosis(AS).Methods 44 normal control subjects(NC),42 obese subjects with normal glucose tolerance(Ob) and 60 newly diagnosed type-2 diabetes mellitus subjects(T2DM) were recruited.Body mass index(BMI),waist-to-hip ratio(WHR),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglycerides(TG),cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG) and OGTT 2-hour postpradial glucose(2-hPG) were also measured.Insulin sensitivity index(ISI) was accessed using Bergman’s minimal model method and IMI of CCA was measured using B mode colorful Doppler ultrasonography.Results The values of CCA-IMT were increased significantly in newly diagnosed T2DM patients when compared with patients of the NC(P<0.01) and Ob(P<0.05) group.According to the results of logistic regression analysis,the CCA-IMT value in patients of T2DM group was positively correlated with age,TC,LDL-C,2-hPG and ISI,but negatively associated with BMI,WHR(r = 0.311,0.264,0.285,0.447,0.325,-0.276,-0.294,all P<0.05).After age adjustment,only 2-hPG was positively correlated with IMT(r=0.461,P<0.001).Conclusion 2-hPG was found to be an independent risk factor of abnormal CCA-IMT,indicating that the control of 2-hPG will improve atherosclerosis in type-2 diabetic patients.更多还原