摘要
目的量化研究脂代谢紊乱以及肥胖对于2型糖尿病(type 2 diabetes mellitus,T2DM)患者发生心血管疾病和因此导致死亡的危险度。方法本研究纳入T2DM患者1134例,基于体质量指数(body mass index,BMI)分为3组,利用S-N-K检验和χ~2检验对比分析不同肥胖程度患者的基本特征差异,筛选最优指标腹部脂肪作为肥胖的评估指标,基于Cox比例风险模型分析脂代谢紊乱受试者发生心血管疾病和死亡风险比。结果 3组受试者的年龄、性别、收缩压、舒张压等比较,差异无统计学意义(P>0.05)。受试者的腰围和腹部脂肪组织随着BMI的增高呈增加趋势,差异具有统计学意义(P<0.05)。BMI≤30 kg/m^2的受试者,其每周进行体育锻炼的时间高于BMI>30 kg/m^2的受试者。3组服用降血糖药物(χ~2=10.821,P=0.005)、降压药(χ~2=16.088,P<0.001)及胰岛素(χ~2=27.447,P<0.001)的患者比例比较,差异有统计学意义。在实验期间,210例发生心血管疾病,135例因心血管疾病死亡。BMI、腰围以及腹部脂肪与受试者发生心血管疾病以及因心血管疾病导致死亡并不存在统计上的相关性,而脂代谢异常与受试者发生心血管疾病以及因心血管疾病导致死亡存在相关性,且具有统计学意义。结论脂代谢状态在T2DM患者心血管疾病的危险性评估中具有重要的临床意义。
Objectives To quantitatively analyze the effect of dyslipidemia and obesity in type2diabetes(T2DM)pa?tients with cardiovascular disease and the risk of death.Methods The study enrolled1134patients with T2DM.Theywere divided into three groups based on body mass index(BMI).S-N-K test andχ2test were used to analysis the ba?sic characteristics of the patients with different degree of obesity.Abdominal fat was selected as an evaluation indexof the obesity.Dyslipidemia on the risk of cardiovascular disease and death was analyzed based on Cox proportionalhazards model.Results Age,gender,systolic pressure and diastolic blood pressure had no statistical differencesamong the three groups.Waist circumference and bdominal adipose tissue(AT)increased with BMI increased,which was statistical significance.Duration of weekly exercise in patients with BMI≤30kg/m2was significantly higherthan that in patients with BMI>30kg/m2.Percentages of patients who took medicine of glucose lowering(χ2=10.821,P=0.005),blood pressure lowering(χ2=16.088,P<0.001)and insulin(χ2=27.447,P<0.001)were statistical differ?ences among the three groups.During the experiment period,210patients occurred cardiovascular diseases and68pa?tients died of cardiovascular diseases.BMI,waist circumference and abdominal fat had no relationships with cardiovas?cular disease and death in patients with T2DM.Lipid metabolism disorder had relationship with cardiovascular diseaseand death in patients with T2DM,which was statistically significant.Conclusions Lipid metabolism condition forevaluating risks of cardiovascular disease in patients with T2DM has important clinical significance.
作者
徐杰
李伟
杨辉
XU Jie;LI Wei;YAGN Hui(Department of Endocrinology,Affiliated Hospital of Yan′an University,Yan′an,Shan′xi 716000,China;Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xian 710002,China)
出处
《岭南心血管病杂志》
2017年第6期759-763,共5页
South China Journal of Cardiovascular Diseases
关键词
心血管疾病
脂代谢紊乱
肥胖
2型糖尿病
cardiovascular disease
dyslipidemia
obesity
type 2 diabetes mellitus
