摘要
目的探讨2型糖尿病(T2DM)患者发生结直肠腺瘤的危险因素。方法选取T2DM且行结肠镜检查的患者204例,其中98例符合伴发结直肠腺瘤型息肉的T2DM患者作为病例组,采用回顾性病例对照的研究方法,进行风险因素的分析。对照组为106例未合并结直肠腺瘤型息肉的T2DM患者。结果单因素回归分析表明,两组间无论在年龄、性别、病程、吸烟、体质量指数(BMI)、血脂水平、血清C肽均无统计学差异(P>0.05),而两组间尿酸水平、使用胰岛素、糖化血红蛋白(HbA_(1C))、胰岛素样生长因子1(IGF-1)均有统计学差异(P<0.05)。多因素Logistic回归分析显示,能够独立影响结直肠腺瘤的危险因素有HbA_(1C)(OR=1.50,95%CI 0.84~2.57)、IGF-1(OR=2.09,95%CI 1.61~3.21)、使用外源性胰岛素24月及以上(OR=1.42,95%CI 1.10~2.95)、36月及以上(OR=1.88,95%CI 1.18~3.37)。结论 HbA_(1C)水平可能成为预测T2DM发生结直肠腺瘤的危险因素,IGF-1是T2DM发生结直肠腺瘤的独立危险因素,IGF-1有可能成为结直肠腺瘤的筛查指标,使用外源性胰岛素24月及以上、36月及以上的T2DM患者可能增加发生结直肠腺瘤的风险。
Objective To investigate the risk factors of colorectal adenoma（CRA） in patients with type 2 diabetes mellitus（T2DM）.Methods Totally 204 patients with T2DM underwent colonoscopy were selected,among them,98 patients with T2 DM and colorectal adenoma polyps were selected as the case group.The risk factors were analyzed by retrospective case-control method.Totally 106 patients with T2DM without colorectal adenoma polyps were selected as the control group.Results Univariate regression analysis showed that there was no significant difference in age,sex,duration,smoking,BMI,serum lipids and serum C-peptide between the two groups（P 〉 0.05）,but the difference of urinary acid level,insulin time,HbA1C,IGF-1 between the two groups were statistically significant（P 〈 0.05）.Multivariate logistic regression analysis showed that these factors could independently affect colorectal adenoma： HbA1C（OR = 1.50,95% CI 0.84-2.57）,IGF-1（OR = 2.09, 95% CI 1.61-3.21）, using exogenous insulin ≥ 24 months（OR = 1.42,95% CI 1.10-2.95）, ≥ 36 months（OR =1.88,95% CI 1.18-3.37）.Conclusion Hb A1 Cmay be a risk factor for predicting colorectal adenoma in T2DM,IGF-1 may be an independent risk factor for colorectal adenoma in type 2 diabetes mellitus,and IGF-1 may be a screening index for colorectal adenoma.The use of exogenous insulin ≥24 months,≥36 months of T2DM patients may increase the risk of colorectal adenoma.
作者
廖镜波
吴进峰
孙致连
朱丹华
张瑞芬
唐平
李红晖
Liao Jingbo Wu Jinfeng Sun Zhilian Zhu Danhua Zhang Ruifen Tang Ping Li Honghui(Luohu District People＇s Hospital, Shenzhen, Guangdong, China 518001)
出处
《中国药业》
CAS
2017年第7期43-45,共3页
China Pharmaceuticals
基金
广东省深圳市罗湖区科技创新局立项项目[2014007]
关键词
2型糖尿病
结直肠腺瘤
胰岛素治疗
危险因素
type 2 diabetes mellitus
colorectal adenoma
insulin therapy
risk factor
