血清胱抑素C与2型糖尿病亚临床心血管疾病相关性的临床研究
发布时间：2018-08-06 18:23
【摘要】：目的:本研究选取颈部动脉粥样硬化斑块(carotid atherosclerotic plaques,CAP)作为亚临床心血管疾病的标志,旨在探讨血清胱抑素C(cystatin C,CysC)与2型糖尿病(type 2 diabetes,T2DM)亚临床心血管疾病的相关性。方法:选择2016年6月-7月于沈阳军区总医院体检中心行体检的人群及同时期内分泌科住院的T2DM患者,共1020名(大于18周岁),其中男866名,女154名。收集性别、年龄、身高、体重、体重指数(BMI)、腰围(WC)、臀围(HC)、既往病史及用药情况、主要生化指标包括空腹血糖(FPG)、糖化血红蛋白(Hb A1C)、血尿素、血肌酐(Scr)、CysC及血甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等生化指标及颈部动脉超声检查结果的相关信息,并计算肾小球滤过率(e GFR)。根据是否有T2DM及CAP的形成,在上述体检人群中,以性别一致、年龄±5岁、病例数为1:1的比例进行匹配,检出T2DM-CAP组(T2DM-CAP,n=111)、T2DM非CAP组(T2DM-NCAP,n=111)、非T2DM-CAP组(NT2DM-CAP,n=111)及非T2DM非CAP组(NT2DM-NCAP,n=111)。结果:1.与T2DM-NCAP、NT2DM-CAP、NT2DM-NCAP组相比,T2DM-CAP组Hb A1C、e GFR、CysC均高于其他三组,并且均有统计学差异(P0.05)。2.与T2DM-CAP组相比,T2DM-NCAP组Hb A1C、e GFR、CysC均较低,并且均有统计学差异(P0.05),血脂、同型半胱氨酸(HCY)、超敏C反应蛋白(HCY)、LC、WC无统计学差异;NT2DM-CAP、NT2DM-NCAP组有统计学差异的是WC、Hb A1C、FPG、TG、TC、Scr、e GFR、CysC(P0.05)。3.T2DM患者发生CAP的独立危险因素:以T2DM组是否合并CAP为因变量,以T2DM-CAP与T2DM-NCAP组有差异的Hb A1c、e GFR、Scr、CysC自变量进行二元logistic回归分析,CysC(OR=4.759,P=0.001)是其发生的独立预测因子。4.T2DM组(T2DM-NCAP+T2DM-CAP组)血糖控制水平与CAP形成的关系:血糖控制不达标组CAP形成人数为66/109(60.6%),而血糖控制达标组为41/108(38.3%)。5.各组间CysC浓度变化的比较:T2DM-CAP明显高于其他三组,且均有统计学差异(P0.05);非糖尿病组,NT2DM-CAP组浓度高于NT2DM-NCAP组,有统计学差异(P0.05)。6.CysC水平与年龄、WC、LC、Scr、Hs-CRP呈正相关,与e GFR及HDL呈负相关。7.以CysC为检验变量,以T2DM-CAP为因变量制作ROC曲线图,曲线下面积0.552,P值0.189。结论:1.低e GFR、高CysC、Hb A1c(≥7%)与T2DM患者形成CAP有关。2.在T2DM组与NT2DM组,CysC可能与CAP形成均有关。3.CysC可能是T2DM患者形成CAP的独立预测因子。4.CysC可能与炎症反应、腹型肥胖有关。5.T2DM患者中,CysC对CAP的形成无诊断价值。
[Abstract]:Objective: to select carotid atherosclerotic plaques (CAP) as a marker of subclinical cardiovascular disease, and to explore the correlation between serum cystatin C (cystatin C, CysC) and type 2 diabetes (type 2 diabetes, T2DM) subclinical cardiovascular disease. Methods: to select the June 2016 -7 month in Shenyang military area general medicine. The population of the physical examination center and the T2DM patients in the same period Department of Endocrinology were 1020 (more than 18 years old), including 866 men and 154 women, including sex, age, height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), past medical history and drug use, the main biochemical indexes including fasting blood glucose (FPG), glycated hemoglobin (Hb A1C). ) blood urea, serum creatinine (Scr), CysC and blood triglyceride (TG), cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and other biochemical parameters of the carotid artery ultrasound, and calculate the glomerular filtration rate (E GFR). According to whether there is the formation of T2DM and CAP, the sex is the same, the age is 5. The number of cases was matched with the proportion of 1:1, T2DM-CAP group (T2DM-CAP, n=111), T2DM non CAP group (T2DM-NCAP, n=111), non T2DM-CAP group (NT2DM-CAP, n=111) and non T2DM, and the results were all higher than those of the other three groups, and all were statistically significant. Compared with the T2DM-CAP group, the T2DM-NCAP group Hb A1C, e GFR, CysC are all lower, and there are statistical differences (P0.05), blood lipid, homocysteine (HCY) and the hypersensitivity C reactive protein (P0.05). Independent risk factors of AP: two yuan logistic regression analysis was carried out in group T2DM, Hb A1c, e GFR, Scr, CysC independent variable, with whether the group of T2DM was combined with CAP as the dependent variable. The number of CAP formation in the control group was 66/109 (60.6%), while the blood glucose control group was compared with the CysC concentration in each group of 41/108 (38.3%).5.: T2DM-CAP was significantly higher than the other three groups, and there were statistical differences (P0.05). The concentration of NT2DM-CAP group was higher than that of the NT2DM-NCAP group, and there was a statistical difference (P0.05).6.CysC level and age, WC. C, Scr, Hs-CRP are positively correlated, and E GFR and HDL are negatively correlated.7. with CysC as the test variable, ROC curves are made with T2DM-CAP as the dependent variable. The area under the curve is 0.552, the P 0.189. conclusion is 1.. CysC may be associated with inflammation and abdominal obesity. 5. CysC has no diagnostic value for CAP formation in T2DM patients.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R54
本文编号：2168596
[Abstract]:Objective: to select carotid atherosclerotic plaques (CAP) as a marker of subclinical cardiovascular disease, and to explore the correlation between serum cystatin C (cystatin C, CysC) and type 2 diabetes (type 2 diabetes, T2DM) subclinical cardiovascular disease. Methods: to select the June 2016 -7 month in Shenyang military area general medicine. The population of the physical examination center and the T2DM patients in the same period Department of Endocrinology were 1020 (more than 18 years old), including 866 men and 154 women, including sex, age, height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), past medical history and drug use, the main biochemical indexes including fasting blood glucose (FPG), glycated hemoglobin (Hb A1C). ) blood urea, serum creatinine (Scr), CysC and blood triglyceride (TG), cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and other biochemical parameters of the carotid artery ultrasound, and calculate the glomerular filtration rate (E GFR). According to whether there is the formation of T2DM and CAP, the sex is the same, the age is 5. The number of cases was matched with the proportion of 1:1, T2DM-CAP group (T2DM-CAP, n=111), T2DM non CAP group (T2DM-NCAP, n=111), non T2DM-CAP group (NT2DM-CAP, n=111) and non T2DM, and the results were all higher than those of the other three groups, and all were statistically significant. Compared with the T2DM-CAP group, the T2DM-NCAP group Hb A1C, e GFR, CysC are all lower, and there are statistical differences (P0.05), blood lipid, homocysteine (HCY) and the hypersensitivity C reactive protein (P0.05). Independent risk factors of AP: two yuan logistic regression analysis was carried out in group T2DM, Hb A1c, e GFR, Scr, CysC independent variable, with whether the group of T2DM was combined with CAP as the dependent variable. The number of CAP formation in the control group was 66/109 (60.6%), while the blood glucose control group was compared with the CysC concentration in each group of 41/108 (38.3%).5.: T2DM-CAP was significantly higher than the other three groups, and there were statistical differences (P0.05). The concentration of NT2DM-CAP group was higher than that of the NT2DM-NCAP group, and there was a statistical difference (P0.05).6.CysC level and age, WC. C, Scr, Hs-CRP are positively correlated, and E GFR and HDL are negatively correlated.7. with CysC as the test variable, ROC curves are made with T2DM-CAP as the dependent variable. The area under the curve is 0.552, the P 0.189. conclusion is 1.. CysC may be associated with inflammation and abdominal obesity. 5. CysC has no diagnostic value for CAP formation in T2DM patients.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R54
【参考文献】
相关期刊论文 前4条
1 孔维敏;刘林;薛存屹;高昕;欧胜胜;楼青青;;颈动脉内中膜增厚及斑块对中风和冠心病事件的影响[J];中国热带医学;2016年01期
2 王咏波;王景红;杜建玲;;胱抑素C在糖尿病及其血管并发症中的研究进展[J];中华内分泌代谢杂志;2014年10期
3 魏富春;戎健;陈玉群;干雪梅;于长青;陈静;杨沛;陈金华;;2型糖尿病患者冠状动脉粥样硬化与视网膜病变的关系[J];中国动脉硬化杂志;2013年08期
4 周晓峰;王佐;;内皮祖细胞在动脉粥样硬化进程中的作用[J];中国动脉硬化杂志;2007年12期
，本文编号：2168596
本文链接：https://www.wllwen.com/yixuelunwen/nfm/2168596.html
最近更新
教材专著
