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目的探讨T2DM患者心血管病危险因素与不同血糖水平的相关性。方法选择健康对照(NC)者240名,T2DM组350例。收集两组病程、BMI、FPG及HbA_1c等水平,并进行比较,分析HbA_1c与心血管各项指标的相关性。结果 T2DM组FPG、TG、TC、LDL-C、24h平均脉压(PP)、左室重量(LVM)和B型脑钠肽前体(NT-proBNP)较NC组升高,左室舒张早期与晚期二尖瓣最大血流速比值(E/A)、左室射血分数(LVEF)、HDL-C较NC组降低(P<0.05)。7.0%≤HbA_1c<8.0%亚组FPG、24hPP、LVM、NT-proBNP、SBP、TC较6.0%≤HbA_1c<7.0%亚组升高,E/A、LVEF降低(P<0.05)。HbA_1c≥8.0%亚组FPG、24hPP、LVM、NT-proBNP、SBP、DBP、TC、TG、LDL-C较7.0%≤HbA_1c<8.0%亚组升高,E/A、LVEF、HDL-C降低(P<0.05)。相关分析显示,HbA1c与24hPP、LVM及NTproBNP呈正相关,与E/A及LVEF呈负相关。结论 T2DM患者在血糖控制不佳时易发生心血管系统损害。T2DM和HbA_1c控制差均是心血管疾病发生的独立危险因素。
Objective To investigate the relationship between cardiovascular risk factors and different blood glucose levels in T2DM patients. Methods 240 healthy controls (NC) and 350 T2DM patients were included. The course of disease, BMI, FPG and HbA_1c were collected and compared, and the correlation between HbA_1c and cardiovascular parameters was analyzed. Results The levels of FPG, TG, TC, LDL-C, mean arterial pressure (PP), left ventricular mass (LVM) and NT-proBNP in T2DM group were significantly higher than those in NC group (E / A), left ventricular ejection fraction (LVEF) and HDL-C in NC group were significantly lower than those in NC group (P <0.05). 7.0% ≤HbA_1c <8.0% subgroup FPG, 24hPP, LVM, NT-proBNP, SBP, TC than 6.0% ≤HbA_1c <7.0% subgroups increased, E / A, LVEF decreased (P <0.05). Compared with 7.0% ≤HbA_1c <8.0% subgroups, HbA_1c≥8.0% FPG, 24hPP, LVM, NT-proBNP, SBP, DBP, TC, TG and LDL-C decreased, E / A, LVEF and HDL-C decreased (P <0.05). Correlation analysis showed that HbA1c was positively correlated with 24hPP, LVM and NTproBNP, but negatively correlated with E / A and LVEF. Conclusions T2DM patients are prone to cardiovascular damage when their blood glucose is poorly controlled. T2DM and HbA_1c control difference are independent risk factors for cardiovascular disease.