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目的研究非糖尿病的代谢综合征(MS)对颈动脉粥样硬化的影响,为临床动脉粥样硬化性心血管疾病的防治提供依据。方法依据国际糖尿病联盟MS诊断标准将446例非糖尿病患者分为非MS组(298例)及MS组(148例),应用彩色多普勒超声检测颈动脉血管结构及功能,分析两组间颈动脉损害情况的差异。结果MS组腰围、甘油三酯、高密度脂蛋白胆固醇、稳态模型评估法的胰岛素抵抗指数、糖化血红蛋白(HbA1c)显著高于非MS组(P<0.01,P<0.05);非MS组动脉斑块发生率仍较高,其颈动脉内膜中层厚度(IMT)和斑块指数与MS组相似,而MS组虽不伴糖尿病,但其HbA1c较非MS组高。直线相关分析显示,IMT与总胆固醇(TC)、年龄、HbA1c、收缩压呈正相关(P<0.01,P<0.05);逐步回归分析显示IMT与TC、年龄、HbA1c相关。结论MS在不合并糖尿病时,其颈动脉损害仍较明显,HbA1c明显升高,可能预示MS易发展为糖尿病和较严重的动脉粥样硬化性心血管疾病。
Objective To study the effect of non-diabetic metabolic syndrome (MS) on carotid atherosclerosis and provide evidence for the prevention and treatment of atherosclerotic cardiovascular disease. Methods 446 non-diabetic patients were divided into non-MS group (298 cases) and MS group (148 cases) according to the International Diabetes Federation MS diagnostic criteria. The structure and function of carotid arteries were detected by color Doppler sonography. Differences in arterial damage. Results The insulin resistance index and HbA1c of waist circumference, triglyceride, high density lipoprotein cholesterol and steady-state model in MS group were significantly higher than those in non-MS group (P <0.01, P <0.05) The incidence of plaque was still high. The carotid intima-media thickness (IMT) and plaque index were similar to those in MS group. However, MS group was not associated with diabetes, but HbA1c was higher than non-MS group. Linear correlation analysis showed that IMT was positively correlated with total cholesterol (TC), age, HbA1c and systolic blood pressure (P <0.01, P <0.05). Stepwise regression analysis showed that IMT was related to TC, age and HbA1c. Conclusion In the absence of diabetes mellitus, MS still has obvious carotid damage and HbA1c significantly increased, which may indicate that MS is susceptible to developing diabetes and severe atherosclerotic cardiovascular disease.