C肽与2型糖尿病患者颈部血管病变相关性研究

发布时间：2018-06-16 09:03

  本文选题：2型糖尿病 + C肽　； 参考：《皖南医学院》2017年硕士论文

【摘要】：目的:探讨血清C肽与2型糖尿病患者颈部血管病变之间的关系。使用Logistic回归分析2型糖尿病患者颈部血管病变的危险因素,采用受试者工作曲线(ROC曲线)对血清C肽诊断2型糖尿病患者颈部血管病变的最佳临界值进行初步探讨,进行诊断性评价。方法:收集住院的2型糖尿病患者203例,对所有患者进行颈部血管彩超检查,观察颈动脉中膜厚度(IMT),有无斑块,记录患者体重指数(BMI)、吸烟史、性别、年龄、糖尿病病程,监测空腹血糖(FBG)及餐后2小时血糖(PBG)、空腹及餐后2小时C肽、糖化血红蛋白、低密度脂蛋白、高密度脂蛋白、血清胆固醇、甘油三酯。IMT值1.0毫米为无颈部血管病变组(对照组),IMT在≥1.0毫米为颈部血管病变组,比较两组之间的C肽水平和其他相关指标,并用Logistic回归分析2型糖尿病患者颈部血管病变的危险因素,最后采用受试者工作曲线(ROC曲线)对血清C肽水平诊断2型糖尿病患者颈部血管病变的最佳临界值进行初步探讨,进行诊断性评价。结果:1、两组间各指标的比较:颈部血管病变组的空腹C肽、餐后2小时C肽、高密度脂蛋白均低于对照组,Hb A1C、糖尿病病程、低密度脂蛋白均高于对照组,差异有统计学意义。2、Logistic回归分析显示,进入回归方程的变量是2型糖尿病病程、空腹C肽、餐后2小时C肽、低密度脂蛋白、高密度脂蛋白、吸烟、糖化血红蛋白。3、ROC曲线显示空腹C肽诊断2型糖尿病合并颈部血管病变最佳临界值为1.81ng/ml,曲线下面积为0.738,标准差为0.035,可信区间为0.669~0.806。餐后2小时C肽识别和诊断亚临床的最佳临界值为5.03ng/ml,曲线下面积为0.777,标准差为0.032,可信区间为0.714~0.840。结论:1、2型糖尿病患者合并颈部血管病变时空腹、餐后2小时C肽、高密度脂蛋白下降,糖化血红蛋白、低密度脂蛋白升高。2、2型糖尿病患者合并颈部血管病变的危险因素有2型糖尿病病程、空腹C肽、餐后2小时C肽、低密度脂蛋白、高密度脂蛋白、吸烟、糖化血红蛋白。3、2型糖尿病患者空腹C肽水平低于1.82ng/ml,进食后120分钟C肽低于5.03ng/ml时发生颈部血管病变的风险增加。
[Abstract]:Objective: to investigate the relationship between serum C-peptide and cervical vascular lesions in type 2 diabetes mellitus. Logistic regression analysis was used to analyze the risk factors of cervical vascular disease in type 2 diabetic patients. The optimal critical value of serum C-peptide in the diagnosis of cervical vascular disease in type 2 diabetes mellitus was preliminarily studied by using the operating curve of subjects and ROC curve. Diagnostic evaluation was performed. Methods: 203 inpatients with type 2 diabetes mellitus were examined by color Doppler ultrasonography. Carotid intima-media thickness (IMT), plaques, body mass index (BMI), smoking history, sex, age, course of diabetes were recorded. Fasting blood glucose (FBG) and 2 hours postprandial blood glucose (PBGG), fasting and 2 hours postprandial C-peptide, glycosylated hemoglobin, low density lipoprotein, high density lipoprotein, serum cholesterol were monitored. Triglyceride. IMT value was 1.0 mm in non-cervical vascular lesion group (control group 鈮，

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