目的 探讨2型糖尿病患者发生冠心病的相关危险因素。方法 选择2型糖尿病216例，根据是否合并冠心病分为单纯2型糖尿病组(n=119)和2型糖尿病合并冠心病组(n=97)，分别检测两组的尿微量白蛋白与肌酐比值(urinary albumin creatinine ratio， UACR)，游离脂肪酸(free fatty acid， FFA)，同型半胱氨酸(Homocysteine， Hcy)，logistic 回归分析2型糖尿病患者发生冠心病的危险因素。结果 与单纯2型糖尿病组比较，2型糖尿病合并冠心病组的FFA、UACR、Hcy，明显升高[(0.80±0.35)mmol/L vs(0.53±0.20)mmol/L，P=0.035; (65.80±7.50)mg/g vs (40.99±6.07) mg/g，P=0.029;(19.36±6.33)μmol/L vs (12.93±7.07)μmol/L，P=0.033]。多因素logistic 回归分析显示，FFA (OR=2.335，95%CI:1.770~4.018，P=0.018)、UACR(OR=1.166，95%CI:1.082~2.330，P=0.032)、Hcy (OR=2.113，95%CI:1.810~3.770，P=0.026)为2型糖尿病患者发生冠心病的危险因素。结论 FFA、UACR、Hcy均为2型糖尿病患者发生冠心病的相关危险因素，应对这部分人群进行积极的干预和治疗。
Abstract
Objective To study the risk factors for coronary heart disease (CHD) in patients with type 2 diabetes mellitus.Methods A total of 216 inpatients with type 2 diabetes mellitus were divided into type 2 diabetes mellitus only group (n=119) and type 2 diabetes mellitus combined with CHD group (n=97). Their values of the urinary microalbumin/creatinine ratio(UACR) and their serum levels of free fatty acid (FFA),homocysteine (Hcy) were measured. The logistic regression model was used to determine the risk factors for CHD.Results The value of UACR and the serum levels of FFA and Hcy were significantly higher in type 2 diabetes mellitus combined with CHD group than in type 2 diabetes mellitus only group[(65.80±7.50) mg/g vs (40.99±6.07)mg/g,P=0.029;(0.80±0.35)mmol/L vs(0.53±0.20)mmol/L,P=0.035;(19.36±6.33)μmol/L vs(12.93±7.07)μmol/L,P=0.033]. Logistic regression analysis showed that FFA (OR=2.335,95%CI:1.770-4.018,P=0.018), UACR(OR=1.166,95%CI:1.082-2.330,P=0.032), and Hcy (OR=2.113,95%CI:1.810-3.770,P=0.026) were the risk factors for CHD.Conclusions FFA,UACR and Hcy are risk factors for CHD in patients with type 2 diabetes mellitus.
关键词
2型糖尿病 /
冠心病 /
游离脂肪酸 /
微量白蛋白与肌酐比值 /
同型半胱氨酸 /
危险因素
Key words
type 2 diabetes mellitus /
coronary heart disease /
free fatty acid /
microalbumin/creatinine ratio /
homocysteine /
risk factor
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