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目的探讨糖尿病患者脂代谢紊乱对糖尿病大血管病变的影响。方法 2006年10月至2007年2月在上海交通大学医学院附属瑞金医院内分泌代谢病科门诊,就诊的2型糖尿病患者1000例,纳入本研究905例,分为肱-踝动脉脉搏波传导速度(baPWV)<1400 mm/s及≥1400 mm/s两组,所有受试者均进行身高、体重、腰围、血压等检查,糖化血红蛋白、血脂及baPWV检测。结果 baPWV升高组较baP-WV正常组年龄较大、糖尿病病程长、体重指数(BMI)、腰围较大,收缩压、舒张压较高,糖化血红蛋白、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)升高(P均<0.05)。校正年龄、性别、BMI、糖化血红蛋白、腰围、收缩压、舒张压后,仅有TG与baPWV异常升高相关性存在,OR(95%CI)为1.87(1.26～2.99)。而HDL-C与baPWV异常升高无显著相关。结论糖尿病患者中血脂异常与baPWV升高相关,特别TG升高与baPWV升高独立相关。
Objective To investigate the effect of lipid metabolism disorder on diabetic macroangiopathy in diabetic patients. Methods From October 2006 to February 2007, 1000 patients with type 2 diabetes were enrolled in the Department of Endocrine and Metabolic Diseases, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine and included 905 cases of this study. The patients were divided into brachial-ankle pulse wave velocity (baPWV) <1400 mm / s and ≥1400 mm / s. All subjects were examined for height, weight, waist circumference, blood pressure, glycosylated hemoglobin, lipids and baPWV. Results Compared with the normal baPWV group, the baPWV increased group had longer age, longer duration of diabetes, higher body mass index (BMI), larger waist circumference, higher systolic and diastolic blood pressure, higher levels of glycosylated hemoglobin, triglyceride (TG) and total cholesterol TC) and low density lipoprotein cholesterol (LDL-C) increased (all P <0.05). Correlation of age, gender, BMI, glycosylated hemoglobin, waist circumference, systolic blood pressure, and diastolic blood pressure was only associated with an abnormal increase of baPWV. The OR (95% CI) was 1.87 (1.26-2.99). HDL-C and baPWV was no significant correlation. Conclusion In patients with diabetes, dyslipidemia is associated with an increase in baPWV. In particular, elevated TG is independently associated with increased baPWV.