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目的探讨初发2型糖尿病(T2DM)人群中颈动脉内中膜厚度(IMT)与各代谢指标的相关关系,探寻动脉粥样硬化的危险因素。方法选择正常对照组(NC)44例、糖耐量正常的单纯肥胖组(Ob)42例、新诊的2型糖尿病患者60例,所有对象于清晨空腹测量身高、体重、腰围、臀围、血压,计算体重指数(BMI)和腰臀比(WHR);空腹检测各组生化指标,并同时行糖耐量试验(OGTT),检测OGTT中0、30、60、120min各时点血糖及胰岛素值,利用Bergman最小模型技术计算胰岛素敏感指数(ISI);并以高分辨率彩色血管多普勒超声检查颈总动脉(CCA)内中膜厚度。结果IMT值T2DM组较NC组(P<0.01)及Ob组显著升高(P<0.05)。所有初发T2DM患者,IMT与年龄、甘油三酯(TC)、低密度脂蛋白(LDL-C)、餐后2h血糖(2hPG)及ISI呈正相关(P<0.05～0.01);与BMI、腰围呈负相关(P<0.05)。在校正年龄、性别因素的影响后,IMT与BMI、腰围、TC、LDL-C及ISI无显著相关,与2hPG呈显著相关(r=0.461,P<0.001)。结论2hPG是初发T2DM人群早期动脉粥样硬化(AS)的独立危险因素,降低2hPG有望改善T2DM人群的血管功能。
Objective To explore the relationship between carotid intima - media thickness (IMT) and various metabolic parameters in newly diagnosed type 2 diabetes mellitus (T2DM) and to explore the risk factors of atherosclerosis. Methods Forty - four patients with normal glucose tolerance (NC), 42 with simple obesity (Ob) and 60 with newly diagnosed type 2 diabetes mellitus were enrolled in this study. All subjects were asked to measure their height, weight, waist circumference, hip circumference, blood pressure , Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. The biochemical indexes of each group were measured by fasting test and the glucose tolerance test (OGTT) Insulin sensitivity index (ISI) was calculated using the Bergman minimum model technique; and medial thickness of common carotid artery (CCA) was examined by high-resolution color Doppler sonography. Results IMT T2DM group was significantly higher than NC group (P <0.01) and Ob group (P <0.05). IMT was positively correlated with age, triglyceride (TC), low density lipoprotein (LDL-C), postprandial 2h blood glucose (2hPG) and ISI in all newly diagnosed T2DM patients (P < Was negatively correlated (P <0.05). There was no significant correlation between IMT and BMI, waist circumference, TC, LDL-C and ISI, and significant correlation with 2hPG (r = 0.461, P <0.001) after adjusting for age and gender. Conclusions 2hPG is an independent risk factor for early atherosclerosis (AS) in newly diagnosed T2DM patients. Reducing 2hPG may improve the vascular function in T2DM.