北京大学学报（医学版）
北京大學學報（醫學版）
북경대학학보（의학판）
JOURNAL OF BEIJING MEDICAL UNIVERSITY(HEALTH SCIENCES)
2015年
3期
431-436
,共6页
孙可欣%刘志科%曹亚英%隽娟%项骁%杨成%黄少平%刘晓芬%李娜%唐迅%李劲%吴涛%陈大方%胡永华
孫可訢%劉誌科%曹亞英%雋娟%項驍%楊成%黃少平%劉曉芬%李娜%唐迅%李勁%吳濤%陳大方%鬍永華
손가흔%류지과%조아영%준연%항효%양성%황소평%류효분%리나%당신%리경%오도%진대방%호영화
肱踝脉搏波传导速度%糖尿病,2型%血糖%血红蛋白A ,糖基化%动脉硬化
肱踝脈搏波傳導速度%糖尿病,2型%血糖%血紅蛋白A ,糖基化%動脈硬化
굉과맥박파전도속도%당뇨병,2형%혈당%혈홍단백A ,당기화%동맥경화
Brachial-ankle pulse wave velocity%Diabetes mellitus,type 2%Blood glucose%Hemoglobin A,glycosylated%Arteriosclerosis
目的：：探讨2型糖尿病( type 2 diabetes mellitus, T2DM)患者血糖控制与肱踝脉搏波传导速度( brachial-ankle pulse wave velocity, baPWV)的关系。方法：采用横断面研究设计,对北京市某社区40岁及以上的T2DM患者及非患者进行问卷调查、体格检查、糖化血红蛋白( glycated hemoglobin, HbA1c)及血脂等实验室指标检测、baPWV测量。根据HbA1c结果将患者分为血糖控制良好组和血糖控制不良组,分析血糖控制情况与baPWV之间的相关性。结果：共纳入1341名研究对象,包括733名T2DM患者及608名非患者。与非患者相比,T2DM患者中baPWV异常(baPWV≥1700 cm/s)率较高(40.8% vs.26.8%, P<0.001)。分别以HbA1c<6.5%和HbA1c<7.0%为血糖控制目标时,非患者、血糖控制良好的T2DM患者组、血糖控制不良的T2DM患者组之间的baPWV异常率差异有统计学意义(non-diabetes vs. HbA1c<6.5% T2DM vs. HbA1c≥6.5% T2DM：26.8% vs.32.8% vs.42.6%,P<0.001；non-diabetes vs. HbA1c<7.0% T2DM vs. HbA1c≥7.0% T2DM：26.8% vs.36.0% vs.43.4%,P<0.001)。控制性别、年龄、吸烟、糖尿病家族史、2型糖尿病病程、心血管疾病史、腰臀比、收缩压、舒张压、总甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等因素后进行多重Logistic回归分析,结果显示与非糖尿病人群相比,HbA1c<6.5%的糖尿病患者baPWV异常的OR值为0.927(95%CI 0.560~1.537),HbA1c≥6.5%的糖尿病患者baPWV异常的OR值为1.826(95%CI 1.287~2.591)；与非糖尿病人群相比,HbA1c<7.0%的糖尿病患者OR值为1.210(95%CI 0.808~1.811),HbA1c≥7.0%的糖尿病患者baPWV异常的OR值为1.898(95%CI 1.313~2.745)。结论：社区2型糖尿病患者血糖控制情况与baPWV间存在显著的关联关系,血糖控制不良是baPWV异常的危险因素,良好控制血糖可能能够降低糖尿病患者发生心血管疾病的风险。
目的：：探討2型糖尿病( type 2 diabetes mellitus, T2DM)患者血糖控製與肱踝脈搏波傳導速度( brachial-ankle pulse wave velocity, baPWV)的關繫。方法：採用橫斷麵研究設計,對北京市某社區40歲及以上的T2DM患者及非患者進行問捲調查、體格檢查、糖化血紅蛋白( glycated hemoglobin, HbA1c)及血脂等實驗室指標檢測、baPWV測量。根據HbA1c結果將患者分為血糖控製良好組和血糖控製不良組,分析血糖控製情況與baPWV之間的相關性。結果：共納入1341名研究對象,包括733名T2DM患者及608名非患者。與非患者相比,T2DM患者中baPWV異常(baPWV≥1700 cm/s)率較高(40.8% vs.26.8%, P<0.001)。分彆以HbA1c<6.5%和HbA1c<7.0%為血糖控製目標時,非患者、血糖控製良好的T2DM患者組、血糖控製不良的T2DM患者組之間的baPWV異常率差異有統計學意義(non-diabetes vs. HbA1c<6.5% T2DM vs. HbA1c≥6.5% T2DM：26.8% vs.32.8% vs.42.6%,P<0.001；non-diabetes vs. HbA1c<7.0% T2DM vs. HbA1c≥7.0% T2DM：26.8% vs.36.0% vs.43.4%,P<0.001)。控製性彆、年齡、吸煙、糖尿病傢族史、2型糖尿病病程、心血管疾病史、腰臀比、收縮壓、舒張壓、總甘油三酯、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇等因素後進行多重Logistic迴歸分析,結果顯示與非糖尿病人群相比,HbA1c<6.5%的糖尿病患者baPWV異常的OR值為0.927(95%CI 0.560~1.537),HbA1c≥6.5%的糖尿病患者baPWV異常的OR值為1.826(95%CI 1.287~2.591)；與非糖尿病人群相比,HbA1c<7.0%的糖尿病患者OR值為1.210(95%CI 0.808~1.811),HbA1c≥7.0%的糖尿病患者baPWV異常的OR值為1.898(95%CI 1.313~2.745)。結論：社區2型糖尿病患者血糖控製情況與baPWV間存在顯著的關聯關繫,血糖控製不良是baPWV異常的危險因素,良好控製血糖可能能夠降低糖尿病患者髮生心血管疾病的風險。
목적：：탐토2형당뇨병( type 2 diabetes mellitus, T2DM)환자혈당공제여굉과맥박파전도속도( brachial-ankle pulse wave velocity, baPWV)적관계。방법：채용횡단면연구설계,대북경시모사구40세급이상적T2DM환자급비환자진행문권조사、체격검사、당화혈홍단백( glycated hemoglobin, HbA1c)급혈지등실험실지표검측、baPWV측량。근거HbA1c결과장환자분위혈당공제량호조화혈당공제불량조,분석혈당공제정황여baPWV지간적상관성。결과：공납입1341명연구대상,포괄733명T2DM환자급608명비환자。여비환자상비,T2DM환자중baPWV이상(baPWV≥1700 cm/s)솔교고(40.8% vs.26.8%, P<0.001)。분별이HbA1c<6.5%화HbA1c<7.0%위혈당공제목표시,비환자、혈당공제량호적T2DM환자조、혈당공제불량적T2DM환자조지간적baPWV이상솔차이유통계학의의(non-diabetes vs. HbA1c<6.5% T2DM vs. HbA1c≥6.5% T2DM：26.8% vs.32.8% vs.42.6%,P<0.001；non-diabetes vs. HbA1c<7.0% T2DM vs. HbA1c≥7.0% T2DM：26.8% vs.36.0% vs.43.4%,P<0.001)。공제성별、년령、흡연、당뇨병가족사、2형당뇨병병정、심혈관질병사、요둔비、수축압、서장압、총감유삼지、고밀도지단백담고순、저밀도지단백담고순등인소후진행다중Logistic회귀분석,결과현시여비당뇨병인군상비,HbA1c<6.5%적당뇨병환자baPWV이상적OR치위0.927(95%CI 0.560~1.537),HbA1c≥6.5%적당뇨병환자baPWV이상적OR치위1.826(95%CI 1.287~2.591)；여비당뇨병인군상비,HbA1c<7.0%적당뇨병환자OR치위1.210(95%CI 0.808~1.811),HbA1c≥7.0%적당뇨병환자baPWV이상적OR치위1.898(95%CI 1.313~2.745)。결론：사구2형당뇨병환자혈당공제정황여baPWV간존재현저적관련관계,혈당공제불량시baPWV이상적위험인소,량호공제혈당가능능구강저당뇨병환자발생심혈관질병적풍험。
Objective:To explore the correlation between glycemic control of type 2 diabetes mellitus (T2DM) patients and brachial-ankle pulse velocity (baPWV). Methods:A community-based cross-sec-tional study was conducted in Beijing, China. Every subject underwent physical examinations, glycated hemoglobin ( HbA1 c ) , blood lipid and baPWV measurements and completed a standardized question-naire. T2DM patients were divided into well controlled and poorly controlled groups according to HbA1c levels. The correlation between glycemic control of T2DM patients and baPWV was analyzed. Results:In this study, 1 341 subjects were recruited, including 733 T2DM patients and 608 non-diabetes sub-jects. Compared with non-diabetes subjects, abnormal baPWV ( baPWV≥1 700 cm/s) rate for T2DM patients was higher (40. 8% vs. 26. 8%, P<0. 001). With HbA1c<6. 5% or <7. 0% as the aim of glycemic control in T2DM patients, the abnormal baPWV rates for non-diabetes subjects, well controlled and poorly controlled T2DM patients were significantly different (non-diabetes vs. HbA1c<6. 5% T2DM vs. HbA1c≥6. 5% T2DM: 26. 8% vs. 32. 8% vs. 42. 6%, P <0. 001; non-diabetes vs. HbA1c <7. 0% T2DM vs. HbA1c≥7. 0% T2DM:26. 8% vs. 36. 1% vs. 43. 4%, P<0. 001). After being ad-justed for gender, age, smoking status, diabetes mellitus family history, T2DM duration, cardiovascular diseases ( CVD ) , waist hip ratio ( WHR ) , systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP) , total triglycerides ( TG) , high density lipoprotein cholesterol ( HDL-C) , and low density lipo-protein cholesterol ( LDL-C ) , the Logistic regression models suggested that glycemic control status of T2DM patients was associated with abnormal baPWV. Compared with non-diabetes subjects, the ORs for abnormal baPWV in HbA1 c <6 . 5% T2 DM patients and HbA1 c≥6 . 5% T2 DM patients were 0 . 927 (95%CI 0. 560-1. 537) and 1. 826 (95%CI 1. 287-2. 591). Compared with non-diabetes subjects, the ORs for abnormal baPWV in HbA1c<7. 0% T2DM patients and HbA1c≥7. 0% T2DM patients were 1. 210 (95%CI 0. 808-1. 811) and 1. 898 (95%CI 1. 313-2. 745). Conclusion:The glycemic con-trol status of T2DM patients from communities is significantly associated with baPWV. Poor glycemic con-trol is a risk factor for abnormal baPWV. Keeping HbA1c under control might lower the risk of cardiovas-cular diseases in T2DM patients.
