CAJ | 학술논문

目的探讨代谢综合征(MS)各组分对既往无冠心病(CHD)病史的新诊断2型糖尿病(T2DM)患者心血管疾病(CVD)危险因子及Framingham风险评分(FRV)的影响.方法共纳入212例患者,将MS除血糖外的各个组分进行三分位分组,比较CVD常见危险因子,如吸烟、BMI、血压、血脂异常、糖化血红蛋白(HbAlC)、简易稳态模型法计算的胰岛素抵抗指数(HOMA-IR)水平以及FRV高危、中危组发生率的区别,并通过Logistic回归分析观察MS各个组分对CVD风险的影响.结果随BMI、TG、平均动脉压(MAP)三分位水平增加,CVD各危险因子均呈增加趋势,FRV高危及中危组比例也呈增加趋势；而HDL-C三分位分组变化与此相反.二元Logistic回归分析显示MS各组分:BMI、收缩压、舒张压、HbAlc、TG均是FRV非低危组(中危或高危)的危险因素,其OR值分别为2.794(95％ CI:2.390-2.408)、2.601 (95％ CI:1.974-3.701)、1.476(95％ CI:1.231-2.048)、2.964(95％ CI:1.925-3.282)、1.464(95％ CI:0.934-2.294)；HDL-C为保护性因素,其OR值为0.732(95％ CI:0.023-0.962).Logistic逐步回归分析显示收缩压、BMI、HbAlC、HDL-C进入回归方程,偏回归系数分别为0.784、1.213、1.679、-0.854(均P＜0.05或P＜0.01).结论新诊断的T2DM患者MS各组分均与CVD风险相关,但对CVD危险因子的区分度有所区别,对CVD风险的影响也不同.
목적 탐토대사종합정(MS)각조분대기왕무관심병(CHD)병사적신진단2형당뇨병(T2DM)환자심혈관질병(CVD)위험인자급Framingham풍험평분(FRV)적영향.방법 공납입212례환자,장MS제혈당외적각개조분진행삼분위분조,비교CVD상견위험인자,여흡연、BMI、혈압、혈지이상、당화혈홍단백(HbAlC)、간역은태모형법계산적이도소저항지수(HOMA-IR)수평이급FRV고위、중위조발생솔적구별,병통과Logistic회귀분석관찰MS각개조분대CVD풍험적영향.결과 수BMI、TG、평균동맥압(MAP)삼분위수평증가,CVD각위험인자균정증가추세,FRV고위급중위조비례야정증가추세；이HDL-C삼분위분조변화여차상반.이원Logistic회귀분석현시MS각조분:BMI、수축압、서장압、HbAlc、TG균시FRV비저위조(중위혹고위)적위험인소,기OR치분별위2.794(95％ CI:2.390-2.408)、2.601 (95％ CI:1.974-3.701)、1.476(95％ CI:1.231-2.048)、2.964(95％ CI:1.925-3.282)、1.464(95％ CI:0.934-2.294)；HDL-C위보호성인소,기OR치위0.732(95％ CI:0.023-0.962).Logistic축보회귀분석현시수축압、BMI、HbAlC、HDL-C진입회귀방정,편회귀계수분별위0.784、1.213、1.679、-0.854(균P＜0.05혹P＜0.01).결론 신진단적T2DM환자MS각조분균여CVD풍험상관,단대CVD위험인자적구분도유소구별,대CVD풍험적영향야불동.
Objective To investigate the different impacts of the components of metabolic syndrome (MS) on cardiovascular disease (CVD) risk factors and Framingham risk value (FRV) in newly-diagnosed type 2 diabetes mellitus (T2DM) patients without coronary heart disease (CHD).Methods A total of 212 newly-diagnosed T2DM patients was divided into three groups based on the components of MS,including body mass index (BMI),triglyceride (TG),high density lipoproteins cholesterol (HDL-C),and mean arterial pressure (MAP) tertile,respectively.The general CVD risk factors [smoking,BMI,TG,HDL-C,total cholesterol (TC),low density lipoproteins cholesterol (LDL-C),HbA1 C,homeostasis model assessment of insulin resistance (HOMA-IR),and FRV] were compared among the groups.Logistic regression analysis was used to observe the different impact of MS components on CVD risk.Results With the increasing of BMI,TG and MAP tertiles,all the CVD risk factors and the ratio of FRV middle-risk group or high-risk group had the tendency of augmentation.With the increasing of HDL-C tertiles,all the CVD risk factors and the ratio of FRV middle-risk group or high-risk group was in downtrend.Binary logistic regression analysis indicted that BMI,systolic pressure,diastolic pressure,HbA1 c and TG were risk factors of FRV non-low-risk group (middle-risk and high-risk groups),HDL-C was the protective factor.The odds ratios (ORs) of BMI,systolic pressure,diastolic pressure,HbA1 c,TG and HDL-C were 2.794 (95％ CI:2.390-2.408),2.601 (95 ％ CI:1.974-3.701),1.476 (95 ％ CI:1.231-2.048),2.964 (95 ％ CI:1.925-3.282),1.464(95％ CI:0.934-2.294),and 0.732(95％ CI:0.023-0.962),respectively.Logistic stepwise regression analysis indicated that systolic pressure,BMI,HbA1 C,and HDL-C were entered into the regression equation,and the partial regression coefficient was 0.784,1.213,1.679,and-0.854,respectively (P ＜ 0.05 or P ＜ 0.01).Conclusions All the components of MS in newly-diagnosed T2DM were correlated with CVD risk factors.However,they should be weighed differently.