2型糖尿病患者血糖控制与颈动脉内膜中层厚度的相关性研究

曹亚英; 孙可欣; 项骁; 刘志科; 隽娟; 杨成; 钱捷; 杨超; 宋菁; 黄少平; 刘晓芬; 李娜; 唐迅; 李劲; 吴涛; 陈大方; 胡永华

doi:10.16462/j.cnki.zhjbkz.2016.07.001

文章导航 > 中华疾病控制杂志 > 2016 > 20(7): 647-651

曹亚英, 孙可欣, 项骁, 刘志科, 隽娟, 杨成, 钱捷, 杨超, 宋菁, 黄少平, 刘晓芬, 李娜, 唐迅, 李劲, 吴涛, 陈大方, 胡永华. 2型糖尿病患者血糖控制与颈动脉内膜中层厚度的相关性研究[J]. 中华疾病控制杂志, 2016, 20(7): 647-651. doi: 10.16462/j.cnki.zhjbkz.2016.07.001

引用本文:

CAO Ya-ying, SUN Ke-xin, XIANG Xiao, LIU Zhi-ke, JUAN Juan, YANG Cheng, QIAN Jie, YANG Chao, SONG Jing, HUANG Shao-ping, LIU Xiao-fen, LI Na, TANG Xun, LI Jing, WU Tao, CHEN Da-fang, HU Yong-hua. Relationship between carotid intima-media thickness and glycemic control among type 2 diabetes mellitus patients[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2016, 20(7): 647-651. doi: 10.16462/j.cnki.zhjbkz.2016.07.001

Citation:

CAO Ya-ying, SUN Ke-xin, XIANG Xiao, LIU Zhi-ke, JUAN Juan, YANG Cheng, QIAN Jie, YANG Chao, SONG Jing, HUANG Shao-ping, LIU Xiao-fen, LI Na, TANG Xun, LI Jing, WU Tao, CHEN Da-fang, HU Yong-hua. Relationship between carotid intima-media thickness and glycemic control among type 2 diabetes mellitus patients[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2016, 20(7): 647-651. doi: 10.16462/j.cnki.zhjbkz.2016.07.001

引用本文:

Citation:

CAO Ya-ying, SUN Ke-xin, XIANG Xiao, LIU Zhi-ke, JUAN Juan, YANG Cheng, QIAN Jie, YANG Chao, SONG Jing, HUANG Shao-ping, LIU Xiao-fen, LI Na, TANG Xun, LI Jing, WU Tao, CHEN Da-fang, HU Yong-hua. Relationship between carotid intima-media thickness and glycemic control among type 2 diabetes mellitus patients[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2016, 20(7): 647-651. doi: 10.16462/j.cnki.zhjbkz.2016.07.001

2型糖尿病患者血糖控制与颈动脉内膜中层厚度的相关性研究

doi: 10.16462/j.cnki.zhjbkz.2016.07.001

曹亚英¹,
孙可欣¹,
项骁¹,
刘志科¹,
隽娟¹,
杨成¹,
钱捷¹,
杨超¹,
宋菁¹,
黄少平²,
刘晓芬³,
李娜⁴,
唐迅¹,
李劲¹,
吴涛¹,
陈大方¹,
胡永华^1, ,

1. 北京大学公共卫生学院流行病与卫生统计学系, 北京 100191;
2. 北京市房山区疾病预防控制中心办公室, 北京 102401;
3. 北京市房山区疾病预防控制中心慢性病防治科, 北京 102401;
4. 北京市房山区科学技术委员会办公室, 北京 102488

基金项目:

国家自然科学基金（81230066，81102177，81473043）

详细信息

作者简介:
曹亚英(1990-),女,山西朔州人,在读硕士研究生。主要研究方向:慢性病流行病学。

中图分类号: R587.1;R181.2
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出版历程
- 收稿日期: 2015-12-13
- 修回日期: 2016-04-27

Relationship between carotid intima-media thickness and glycemic control among type 2 diabetes mellitus patients

1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China;
2. General Office, Fangshan District Center for Disease Control and Prevention, Beijing 102401, China;
3. Department of Chronic Disease Control and Prevention, Fangshan District Center for Disease Control and Prevention, Beijing 102401, China;
4. General Office, Fangshan District Science and Technology Commission, Beijing 102488, China

摘要

摘要: 目的探讨社区2型糖尿病（type 2 diabetes mellitus, T2DM）患者血糖控制与颈动脉内膜中层厚度（carotid intima-media thickness, CIMT）的关系。方法对北京市3个农村社区40岁及以上T2DM患者进行糖化血红蛋白（hemoglobin A1c, HbA1c）及血生化指标的检测、CIMT测量、其他体格检查以及一般人口学资料的问卷调查。以HbA1c为血糖控制指标，分析其与CIMT的相关性。结果本次分析共纳入720名T2DM患者，平均年龄为（59.06±7.50）岁，中位糖尿病病程6.3年。相关性分析显示CIMT与HbA1c呈正相关（r_s=0.182, P<0.001）。血糖控制良好组（HbA1c<6.5%）、控制一般组（6.5%≤HbA1c<8.0%）和控制不良组（HbA1c≥8.0%）CIMT增厚率分别为21.98%、28.94%和38.11%（χ²=13.78, P=0.001）。Logistic回归显示，调整年龄、性别、心脑血管病史、血压、血脂、糖尿病用药及病程因素后，HbA1c仍为CIMT增厚的危险因素（OR=1.18,95% CI：1.07~1.31）；与血糖控制良好组相比，血糖控制不良仍为CIMT增厚的危险因素（OR=2.17,95% CI：1.34~3.51）。结论 T2DM患者血糖控制水平与CIMT显著相关；HbA1c≥8.0%可能为T2DM患者动脉粥样硬化的危险因素，且作用独立于血压、血脂水平。
- 糖尿病,2型 /
- 动脉粥样硬化 /
- 危险因素
Abstract: Objective To explore the relationship between carotid intima-media thickness (CIMT) and glycemic control in community type 2 diabetes mellitus (T2DM) patients. Methods A community-based study for T2DM patients aged over 40 years was conducted in three rural communities in Beijing. Every participant underwent hemoglobin A1c (HbA1c) assessment, CIMT measurement, physical examination, biochemical test and a questionnaire investigation. According to the level of HbA1c, T2DM patients were divided into well-controlled group, moderately controlled group and poorly controlled group and then the association between CIMT and glycemic control among T2DM patient was analyzed. Results A total of 720 T2DM patients were recruited. The average age was 59.06±7.50 years old and the mean T2DM duration was 6.3 years. Correlation analysis showed CIMT was positively associated with HbA1c (r_s=0.182, P<0.001). The thickness increase rate of CIMT for well-controlled (HbA1c<6.5%), moderately controlled (6.5%≤HbA1c<8.0%), and poorly controlled (HbA1c≥8.0%) groups were 21.98%, 28.94% and 38.11% respectively (χ²=13.78, P=0.001). Logistic regression analysis showed that after adjusting for age, sex, cardio-cerebral vascular disease history, anti-diabetic drug use, T2DM duration, indexes of blood pressure and lipids, the thickness increase rate of CIMT was associated with HbA1c (OR=1.18,95% CI:1.07-1.31). Compared with the well-controlled group, poor glycemic control remained a risk factor for the elevation of CIMT (OR=2.17, 95% CI:1.34-3.51). Conclusions The level of glycemic control among T2DM patients was associated with CIMT. Poor glycemic control (HbA1c≥8.0%) might be a risk factor for the development of atherosclerosis among T2DM patients and its function is independent of blood pressure and lipid level.
- Diabetes mellitus, type 2 /
- Atherosclerosis /
- Risk factors

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参考文献(34)

Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China [J]. New Engl J Med, 2010,362(12): 1090-1101.

高蕾莉,纪立农,陆菊明,等. 2009-2012年我国2型糖尿病患者药物治疗与血糖控制状况调查 [J]. 中国糖尿病杂志, 2014,22(7):594-598.

DECODE Study Group, European Diabetes Epidemiology Group. Is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular diseases? [J]. Diabetes care, 2003,26(3):688-696.

Turnbull FM, Abraira C, Anderson RJ. et al. Intensive glucose control and macrovascular outcomes in type 2 diabetes [J]. Diabetologia, 2009,52(1):2288-2298.

Bots ML, Dijk JM, Oren A, et al. Carotid intima-media thickness, arterial stiffness and risk of cardiovascular disease:current evidence [J]. J Hypertens, 2002,20(12):2317-2325.

O'Leary DH, Polak JF, Kronmal RA, et al. Distribution and correlates of sonographically detected carotid artery disease in the Cardiovascular Health Study. The CHS Collaborative Research Group [J]. Stroke, 1992,23(12):1752-1760.

Lenters-Westra E, Schindhelm RK, Bilo HJ, et al. Haemoglobin A1c: historical overview and current concepts [J]. Diabetes Res Clin Pract, 2013,99(2):75-84.

Polak JF, Backlund JY, Cleary PA, et al. Progression of carotid artery intima-media thickness during 12 years in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study [J]. Diabetes, 2011,60(2):607-613.

Wang HM, Chen TC, Jiang SQ, et al. Association of conventional risk factors for cardiovascular disease with IMT in middle-aged and elderly Chinese [J]. Int J Cardiovasc imaging, 2014,30(4):759-768.

石春晖,王尧. 2型糖尿病患者糖化血红蛋白,1,5-脱水葡萄糖醇与颈动脉内膜中层厚度的关系 [J]. 糖尿病新世界, 2015,35(10):229-231.

Bobbert T, Mai K, Fischer-Rosinsky A, et al. A1C is associated with intima-media thickness in individuals with normal glucose tolerance [J]. Diabetes care, 2010,33(1):203-204.

杜宏伟. 同时合并高血压和糖尿病的老年人血压和血糖控制与颈动脉粥样硬化的相关性研究 [D]. 北京:中国人民解放军军医进修学院, 2012.

中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2013年版) [J]. 中国糖尿病杂志, 2014,22(8):2-42.

许竹梅,范平. 超声测量颈动脉内膜中层厚度与颈动脉斑块的关系 [J]. 中国动脉硬化杂志, 2000,8(2):165-168.

van der Meer IM, Bots ML, Hofman A, et al. Predictive value of noninvasive measures of atherosclerosis for incident myocardial infarction: the Rotterdam Study [J]. Circulation, 2004,109(9):1089-1094.

Stamatelopoulos KS, Armeni E, Georgiopoulos G, et al. Recently postmenopausal women have the same prevalence of subclinical carotid atherosclerosis as age and traditional risk factor matched men [J]. Atherosclerosis, 2012,221(2):508-513.

Novo S, Visconti CL, Amoroso GR, et al. Asymptomatic carotid lesions add to cardiovascular risk prediction [J]. Eur J Cardiovasc Prev Rehabil, 2010,17(5):514-518.

蔡凯愉,张维忠. 颈动脉内膜中层厚度测定及其临床意义 [J]. 高血压杂志, 2004,12 (3):196-197

孙可欣,刘志科,曹亚英,等. 北京某社区2型糖尿病患者血糖控制情况与肱踝脉搏波传导速度的相关性研究 [J]. 北京大学学报(医学版), 2015,47(3

):431-436.

刘力生. 中国高血压防治指南2010 [J]. 中华高血压杂志, 2011,19(8):701-708.

Mancia G, De Backer G, Dominiczak A, et al. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension [J]. J Hypertens, 2007,25(9):1751-1762.

American Diabetes Association. Standards of medical care in diabetes——2014 [J]. Diabetes care, 2014,37(3):887.

中国肥胖问题工作组. 中国成人超重和肥胖症预防与控制指南(节录) [J]. 营养学报, 2004,26(1):1-4.

King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections [J]. Diabetes care, 1998,21(9):1414-1431.

Bartman W, Pierzchala K. Clinical determinants of carotid intima-media thickness in patients with diabetes mellitus type 2 [J]. Neurol Neurochir Pol, 2012,46(6):519-528.

向光大. 关注高血糖与血管内皮功能异常的关系 [J]. 中国糖尿病杂志, 2007,15(12):705-707.

Danaei G, Lawes CM, Vander Hoorn S, et al. Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment [J]. Lancet, 2006,368(9548):1651-1659.

Pignoli P, Tremoli E, Poli A, et al. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging [J]. Circulation, 1986,74(6):1399-1406.

严子君,张瑞岩,左君丽,等. 颈总动脉内膜-中膜厚度及粥样斑块与冠心病的关系 [J]. 国际心血管杂志, 2008,35(6):399-401.

Lorenz MW, Markus HS, Bots ML, et al. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis [J]. Circulation, 2007,115(4):459-467.

Parildar H, Gulmez O, Cigerli O, et al. Carotid artery intima media thickness and HsCRP; predictors for atherosclerosis in prediabetic patients [J]. Pak J Med Sci, 2013,29(2):495-499.

Kawasumi M, Tanaka Y, Uchino H. et al. Strict glycemic control ameliorates the increase of carotid IMT in patients with type 2 diabetes [J]. Endocr J, 2006,53(1):45-50.

王玲芝,潘丹峰,张园,等. 2型糖尿病患者颈动脉内膜中层厚度危险因素的病例对照研究 [J]. 中华疾病控制杂志, 2011,15(6):466-469.

周吉,周芳华,石健,等. 南宁市35岁以上2型糖尿病患者血糖控制现状及影响因素分析 [J]. 中华疾病控制杂志, 2014,18(9):816-819.

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