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目的:分析2型糖尿病(T2DM)患者糖化血红蛋白(Hb A1c)水平与颈动脉内-中膜厚度(CIMT)的相关性。方法:选择在我院内分泌科住院的T2DM患者328名,对入组患者进行Hb A1c、血生化指标检测以及CIMT测量等。根据CIMT值分为CIMT正常组(<0.9 mm)和CIMT增厚组(>0.9 mm),并对CIMT的相关危险因素进行多因素Logistic回归分析。结果:(1)328名T2DM患者中,CIMT正常154例,CIMT增厚174例;(2)Pearson相关分析显示,总胆固醇(TC)、Hb A1c水平与IMT值呈正相关(P<0.05)。(3)单因素分析示,CIMT正常组和CIMT增厚组两组间年龄(t=4.132,P=0.041)、收缩压(t=8.456,P<0.01)、Hb A1c≥9.0%(x~2=9.912,P<0.01)、总胆固醇(t=5.549,P=0.018)、甘油三酯(t=6.592,P=0.008)、尿酸(t=9.618,P<0.01)、空腹血糖(t=4.592,P=0.037)间差异有统计学意义;(4)多因素Logistic回归分析示,年龄、Hb A1c≥9%、收缩压、总胆固醇是T2DM患者CIMT增厚的独立危险因素(P<0.05)。结论:Hb A1c与CIMT增厚明显相关;且Hb A1c≥9%是CIMT增厚的独立危险因素。
Objective: To analyze the correlation between HbA1c and carotid artery intima - media thickness (CIMT) in type 2 diabetes mellitus (T2DM). Methods: A total of 328 T2DM patients hospitalized in the department of endocrinology were enrolled in this study. Hb A1c, blood biochemical parameters and CIMT were measured. CIMT values were divided into CIMT normal group (<0.9 mm) and CIMT thickening group (> 0.9 mm), and multivariate Logistic regression analysis was used to analyze the related risk factors of CIMT. Results: (1) Among 328 T2DM patients, 154 cases were normal CIMT and 174 cases were CIMT thickened. (2) Pearson correlation analysis showed that total cholesterol (TC) and Hb A1c levels were positively correlated with IMT (P <0.05). (3) Univariate analysis showed that age (t = 4.132, P = 0.041), systolic pressure (t = 8.456, P <0.01) and Hb A1c≥9.0% (T = 9.692, P = 0.008), uric acid (t = 9.618, P <0.01), fasting blood glucose (t = 4.592, P = 0.037). (4) Multivariate Logistic regression analysis showed that age, Hb A1c≥9%, systolic blood pressure and total cholesterol were independent risk factors of CIMT thickening in T2DM patients (P <0.05 ). Conclusions: Hb A1c is significantly associated with thickening of CIMT; and Hb A1c ≥ 9% is an independent risk factor for CIMT thickening.