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目的探讨不同糖代谢状况人群心踝血管指数(CAVI)水平及其影响因素。方法 223例研究对象被分为正常糖耐量(NGT)组56例,空腹血糖异常(IFG)组53例,糖耐量异常(IGT)组58例和初诊2型糖尿病(T2DM)组56例。所有对象均测定体质指数、腰围、腰臀比、收缩压、舒张压、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖、空腹胰岛素及胰岛素抵抗指数(HOMA-IR),并测定CAVI。结果不同糖代谢异常各组的体质指数、腰围、腰臀比、血压、血脂、空腹血糖、空腹胰岛素及HOMA-IR等各项指标均高于NGT组,差异有统计学意义(P<0.05,P<0.01),并随着糖代谢异常的加重,上述指标呈升高趋势。与NGT组(6.8±1.0)比较,IGT组和T2DM组CAVI(分别为8.5±1.6、9.0±1.2)升高,差异有统计学意义(P<0.05,P<0.01)。多因素logistic分析显示,年龄(OR=0.962)、腰围(OR=1.953)、腰臀比(OR=1.235)、收缩压(OR=1.864)、舒张压(OR=1.192)、甘油三酯(OR=0.709)、LDL-C(OR=1.367)、空腹血糖(OR=1.823)、HOMA-IR(OR=2.028)均是CAVI的危险因素,差异有统计学意义(P<0.05)。结论高血糖及腹型肥胖、高血压、高血脂和胰岛素抵抗等均可引起或加速动脉粥样硬化的发生,只有对各个代谢危险因素进行全面干预才能真正减少和延缓心脑血管并发症的发生。
Objective To investigate the level of cardio-ankle vascular index (CAVI) and its influencing factors in different glucose metabolism status. Methods Totally 223 subjects were divided into two groups: normal glucose tolerance (NGT) group (56 cases), fasting blood glucose abnormality group (53), impaired glucose tolerance group (IGT) and newly diagnosed type 2 diabetes mellitus (56 cases). Body mass index, waist circumference, waist-hip ratio, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, HDL-C, LDL-C, , Fasting insulin and insulin resistance index (HOMA-IR), and determination of CAVI. Results The indexes of body mass index, waist circumference, waist-hip ratio, blood pressure, blood lipid, fasting blood glucose, fasting insulin and HOMA-IR in different groups with different glucose metabolism were higher than those in NGT group (P <0.05, P <0.01), and with the aggravation of abnormal glucose metabolism, the above indicators showed an upward trend. Compared with NGT group (6.8 ± 1.0), CAVI (8.5 ± 1.6, 9.0 ± 1.2) in IGT group and T2DM group were significantly higher than that in NGT group (P <0.05, P <0.01). Multivariate logistic analysis showed that age (OR = 0.962), waist circumference (OR = 1.953), waist-hip ratio (OR = 1.235), systolic blood pressure (OR = 1.864), diastolic blood pressure (OR = 1.192), triglyceride = 0.709), LDL-C (OR = 1.367), fasting blood glucose (OR = 1.823) and HOMA-IR (OR = 2.028) were all risk factors for CAVI with statistical significance (P <0.05). Conclusion Hyperglycemia and abdominal obesity, hypertension, hyperlipidemia and insulin resistance can all cause or accelerate the occurrence of atherosclerosis. Only comprehensive intervention of various metabolic risk factors can really reduce and delay the occurrence of cardiovascular and cerebrovascular complications .