目的 探讨血清总胆红素水平与2型糖尿病合并代谢功能障碍患者冠状动脉粥样硬化病变的关系。方法 回顾性分析2016-02至2023-10在秦皇岛市第一医院住院治疗的2型糖尿病合并代谢功能障碍患者的临床资料,依据冠状动脉CT血管造影(CTA)分组,收集两组患者的性别、年龄、血清总胆红素、血脂指标进行比较,并探讨血清总胆红素水平与斑块负荷、受累节段及不同类型斑块之间的相关性。结果 共77例患者入选本研究,依据CTA结果,分为合并冠心病组(n=42)和糖尿病组(n=35)。合并冠心病组血清总胆红素水平显著低于糖尿病组[9.40(7.25~12.53)vs 10.50(6.65~13.95)μmol/L],差异有统计学意义(P<0.05)。合并冠心病组与糖尿病组比较,血清总胆红素水平与斑块数目、病变节段数呈显著负相关(r=-0.82、-0.58,P<0.001),与钙化、非钙化及混合斑块亦呈负相关(r=-0.49、-0.57、-0.92,P<0.05)。结论 2型糖尿病合并冠心病患者血清总胆红素显著降低且与更高冠脉斑块负荷及不稳定斑块特征相关。
Abstract
Objective To explore the correlation between serum total bilirubin and coronary atherosclerotic lesions in patients with Type 2 diabetes (T2DM) complicated with metabolic dysfunction. Methods A retrospective study was conducted on the clinical data of patients with T2DM and metabolic dysfunction who were hospitalized in the First Hospital of Qinhuangdao from February 2016 to October 2023. According to coronary artery computed tomography angiography (CTA) results, the patients were grouped, and the gender, age, serum total bilirubin, and lipid indicators of the two groups were collected for comparison. The correlations between serum total bilirubin levels and plaque burden, involved segments, and plaque phenotypes was also explored. Results A total of 77 patients were included in this study. According to the CTA results, they were divided into a T2DM with the coronary heart disease (CHD) group (n=42) and a T2DM group (n=35).The serum total bilirubin level in the T2DM with CHD group was significantly lower than that in the T2DM group [9.40(7.25-12.53) vs. 10.50(6.65-13.95)μmol/L], and the difference was statistically significant (P<0.05). Compared with T2DM group, the serum total bilirubin levels in the T2DM+CHD group were significantly negatively correlated with plaque number and the number of involved segments (r=-0.82、-0.58,P<0.001), and also negatively correlated with calcification, non-calcification, and mixed plaques (r=-0.49, -0.57, -0.92, P<0.05). Conclusions Serum total bilirubin levels are significantly reduced in T2DM patients with CHD and are associated with higher coronary plaque burden and unstable plaque characteristics.
关键词
2型糖尿病 /
血清总胆红素 /
冠状动脉粥样硬化 /
斑块 /
代谢功能障碍
Key words
type 2 diabetes /
serum total bilirubin /
coronary atherosclerosis /
plaque /
metabolic dysfunction
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