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目的探讨肥胖对初诊2型糖尿病(T2DM)患者大血管病变的影响。方法根据体重指数(BMI)将90例初诊T2DM患者均分为肥胖组(A组,BMI≥28)、超重组(B组,24≤BMI≤27.9)和体重正常组(C组,18.5≤BMI≤23.9)。采用无创动脉硬化检测装置测定肱踝脉搏波传导速度(ba-PWV)和踝肱指数(ABI),血管超声检测颈动脉斑块形成率,同时测定糖化血红蛋白(HbA1c)、血压和血脂。结果 A组和B组ba-PWV、颈动脉斑块形成率、腰围、收缩压(SBP)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平均高于C组(P<0.05);A组舒张压水平(DBP)高于C组(P<0.05)。A组和B组颈动脉斑块形成率高于C组(40%和23%vs.10%)(P<0.05)。TG与ba-PWV呈正相关(r=0.47,P<0.05),TG是ba-PWV的独立危险因素。结论肥胖是初诊T2DM患者外周大血管发生硬化并形成斑块的重要促进因素。
Objective To investigate the effect of obesity on macrovascular complications in newly diagnosed type 2 diabetes mellitus (T2DM). Methods According to body mass index (BMI), 90 newly diagnosed T2DM patients were divided into obesity group (group A, BMI≥28), overweight group (group B, 24≤BMI≤27.9) and normal weight group (group C, 18.5≤BMI ≤23.9). The brachial-ankle pulse wave velocity (ba-PWV) and ankle-brachial index (ABI) were measured by noninvasive arteriosclerosis detection apparatus. The plaque formation rate of carotid artery was detected by ultrasound and the HbA1c, blood pressure and blood lipid were measured simultaneously. Results The levels of ba-PWV, carotid plaque formation, waist circumference, systolic blood pressure (SBP), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) were significantly higher in group A and group B than those in group C <0.05). The diastolic blood pressure (DBP) in group A was higher than that in group C (P <0.05). The carotid plaque formation rates in groups A and B were higher than those in group C (40% vs 23% vs. 10%) (P <0.05). There was a positive correlation between TG and ba-PWV (r = 0.47, P <0.05). TG was an independent risk factor for ba-PWV. Conclusion Obesity is an important contributing factor to the development of plaque in peripheral vessels in newly diagnosed T2DM patients.