2型糖尿病患者血尿酸与颈动脉内膜厚度的关系研究
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摘要
目的了解2型糖尿病患者血清尿酸与颈动脉内膜中层厚度及颈动脉粥样硬化相关危险因素的关系。方法回顾性分析2010年1月～2016年12月我院收治的3570例2型糖尿病患者的临床资料,按彩色多普勒超声分为颈动脉斑块形成组(1888例,颈动脉内膜中层厚度≥1.5 mm或存在颈动脉斑块)、颈动脉中膜增厚组(332例,颈动脉内膜中层厚度≥1.0 mm)和正常组(1350例,颈动脉内膜中层厚度<1.0 mm)。比较患者性别、年龄、病程、体重指数(BMI)、吸烟史、饮酒史、糖尿病家族史、高血压病史、血尿酸、空腹血甘油三酯、空腹血总胆固醇、血低密度脂蛋白(LDL)、血高密度脂蛋白(HDL)、空腹血糖、空腹C肽、糖化血红蛋白、双侧颈动脉内膜中层厚度等资料。结果三组年龄、病程、脑梗死病史、收缩压、血尿酸、LDL、TG、TC、LDL、空腹血糖水平比较,差异均有统计学意义(P<0.05);正常组与颈动脉斑块形成组、正常组与颈动脉内膜增厚组年龄、病程、BMI、高血压病史、脑梗死病史、收缩压、血尿酸、LDL比较,差异均有统计学意义(P<0.05);在糖尿病家族史、冠心病史、足溃疡病史、TG、TC、空腹血糖方面,正常组与颈动脉斑块形成组或正常组与颈动脉内膜增厚组间差异有统计学意义(P<0.05);颈动脉内膜中层增厚组中血尿酸水平与颈动脉中膜厚度正相关(r=0.04,P=0.01)。结论 2型糖尿病患者的血清尿酸水平与颈动脉内膜中层厚度有关,控制2型糖尿病患者的血尿酸水平可以预防和减缓其心血管疾病的进展。
Objective To investigate the relationship between serum uric acid and carotid intima-media thickness and carotid atherosclerosis-related risk factors in patients with type 2 diabetes mellitus.Methods The clinical data of 3570 patients with type 2 diabetes admitted to our hospital from January 2010 to December 2016 were retrospectively analyzed. Color Doppler ultrasound was divided into carotid plaque formation group(1888 cases,carotid intima medial layer,thickness ≥1.5 mm or carotid plaque), carotid intima-media thickening group(332 cases, carotid intima-media thickness≥1.0 mm) and normal group(1350 cases, carotid intima-media thickness <1.0 mm).Comparison of patient gender, age, disease duration, body mass index(BMI), smoking history, drinking history, family history of diabetes, history of hypertension, blood uric acid, fasting blood triglycerides, fasting blood total cholesterol, blood low density lipoprotein(LDL), high-density lipoprotein(HDL), fasting blood glucose, fasting C-peptide, glycated hemoglobin, bilateral carotid intima-media thickness and other data.Results The age, duration of disease, history of cerebral infarction, systolic blood pressure, blood uric acid, LDL, TG, TC, LDL and fasting blood glucose levels were statistically significant(P<0.05). Normal group and carotid plaque formation The age, duration of disease, BMI, history of hypertension, history of cerebral infarction, systolic blood pressure, blood uric acid and LDL were statistically significant(P<0.05). History, history of coronary heart disease, history of foot ulcer, TG, TC, fasting blood glucose, the difference between the normal group and the carotid plaque formation group or the normal group and carotid intima thickening group( P<0.05); Serum uric acid level was positively correlated with carotid medial thickness in the carotid intima-media thickening group( r=0.04, P=0.01). Conclusion Serum uric acid level in patients with type 2 diabetes is related to carotid intima-media thickness. Controlling blood uric acid levels in patients with type 2 diabetes can prevent and slow the progression of cardiovascular disease.
Objective To investigate the relationship between serum uric acid and carotid intima-media thickness and carotid atherosclerosis-related risk factors in patients with type 2 diabetes mellitus.Methods The clinical data of 3570 patients with type 2 diabetes admitted to our hospital from January 2010 to December 2016 were retrospectively analyzed. Color Doppler ultrasound was divided into carotid plaque formation group(1888 cases,carotid intima medial layer,thickness ≥1.5 mm or carotid plaque), carotid intima-media thickening group(332 cases, carotid intima-media thickness≥1.0 mm) and normal group(1350 cases, carotid intima-media thickness <1.0 mm).Comparison of patient gender, age, disease duration, body mass index(BMI), smoking history, drinking history, family history of diabetes, history of hypertension, blood uric acid, fasting blood triglycerides, fasting blood total cholesterol, blood low density lipoprotein(LDL), high-density lipoprotein(HDL), fasting blood glucose, fasting C-peptide, glycated hemoglobin, bilateral carotid intima-media thickness and other data.Results The age, duration of disease, history of cerebral infarction, systolic blood pressure, blood uric acid, LDL, TG, TC, LDL and fasting blood glucose levels were statistically significant(P<0.05). Normal group and carotid plaque formation The age, duration of disease, BMI, history of hypertension, history of cerebral infarction, systolic blood pressure, blood uric acid and LDL were statistically significant(P<0.05). History, history of coronary heart disease, history of foot ulcer, TG, TC, fasting blood glucose, the difference between the normal group and the carotid plaque formation group or the normal group and carotid intima thickening group( P<0.05); Serum uric acid level was positively correlated with carotid medial thickness in the carotid intima-media thickening group( r=0.04, P=0.01). Conclusion Serum uric acid level in patients with type 2 diabetes is related to carotid intima-media thickness. Controlling blood uric acid levels in patients with type 2 diabetes can prevent and slow the progression of cardiovascular disease.
引文
[1]成珍珍,王建华,丁桂春.2型糖尿病患者颈动脉粥样硬化的超声评估和临床相关危险因素分析[J].中华医学超声杂志(电子版),2013,10(6):465-469.
[2]余小艳,石际俊,姜春黎,等.血尿酸水平与rt-PA静脉溶栓卒中患者预后及脑出血转化相关性分析[J].中华医学杂志,2015,95(29):2351-2354
[3]杨欣,丁毅.颈动脉粥样硬化危险因素及意义的研究进展[J].医学综述,2015,21(2):239-241.
[4]刘廷琼,刘育丽.2型糖尿病患者颈动脉粥样硬化危险因素分析及超声评价[J].实用糖尿病杂志,2016,12(2):45-46.
[5]汤广锋,徐雯,李昉.2型糖尿病患者颈动脉粥样硬化斑块形成的危险因素分析[J].安徽医学,2014,35(11):1506-1508.
[6]宋冰冰,王佩,祖赛,等.血尿酸水平与2型糖尿病患者颈动脉粥样硬化的相关性[J].检验医学与临床,2018,15(17):2564-2566.
[7]薛佳,张伟,孙婧,等.高尿酸血症与颈动脉粥样硬化的关系[J].中国循证心血管医学杂志,2015,7(5):684-686.
[8]Kanbay M,Seqal M,Afsar B,et al.The role of uric acid in the pathogenesis of human cardiovascular disease[J].Heart,2013(99):759-766.
[9]Salomon C,Scholz-Romero K,Sarker S,et al.Gestational diabetes mellitus is associated with changes in the concentration and bioactivity of placenta-derived exosomes in maternal circulation ACROSS gestation[J].Diabetes,2016,65(3):598-609.
[2]余小艳,石际俊,姜春黎,等.血尿酸水平与rt-PA静脉溶栓卒中患者预后及脑出血转化相关性分析[J].中华医学杂志,2015,95(29):2351-2354
[3]杨欣,丁毅.颈动脉粥样硬化危险因素及意义的研究进展[J].医学综述,2015,21(2):239-241.
[4]刘廷琼,刘育丽.2型糖尿病患者颈动脉粥样硬化危险因素分析及超声评价[J].实用糖尿病杂志,2016,12(2):45-46.
[5]汤广锋,徐雯,李昉.2型糖尿病患者颈动脉粥样硬化斑块形成的危险因素分析[J].安徽医学,2014,35(11):1506-1508.
[6]宋冰冰,王佩,祖赛,等.血尿酸水平与2型糖尿病患者颈动脉粥样硬化的相关性[J].检验医学与临床,2018,15(17):2564-2566.
[7]薛佳,张伟,孙婧,等.高尿酸血症与颈动脉粥样硬化的关系[J].中国循证心血管医学杂志,2015,7(5):684-686.
[8]Kanbay M,Seqal M,Afsar B,et al.The role of uric acid in the pathogenesis of human cardiovascular disease[J].Heart,2013(99):759-766.
[9]Salomon C,Scholz-Romero K,Sarker S,et al.Gestational diabetes mellitus is associated with changes in the concentration and bioactivity of placenta-derived exosomes in maternal circulation ACROSS gestation[J].Diabetes,2016,65(3):598-609.