目的 探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者心外膜脂肪厚度(epicardial fat thickness,EFT)、主动脉传播速度(aortic velocity propagation,AVP)和颈动脉内-中膜厚度(carotid intima-media thickness,CIMT)之间的关联性。方法 选取2019-11至2020-06武警特色医学中心内分泌与血液科住院的年龄＞18岁未明确诊断冠心病的T2DM患者41例(T2DM组),同时选择37例非糖尿病患者(对照组),所有受试者均采用超声心动图测定EFT和AVP,用超声检查结果计算CIMT。结果 T2DM组EFT[(8.41±1.62)mm]、CIMT[ (0.93±0.21)mm]显著高于对照组[(6.32±2.19)mm、(0.53±0.11)mm],AVP[(28.21±16.03)mm)]显著低于对照组[(58.12±17.49)mm],差异均有统计学意义(P<0.05)。相关性分析显示, EFT和AVP呈显著负相关(r=-0.339,P=0.001),EFT与CIMT呈显著正相关(r=0.415,P<0.001),AVP与CIMT呈显著负相关(r=-0.629,P<0.001)。逐步线性回归分析显示,CIMT是EFT(β1=3.255,95%CI:1.775~4.739,P=0.001)、AVP的独立预测因子(β2=-30.868,95%CI:-45.805~-15.932,P<0.001)。ROC曲线分析显示,EFT 7.2 mm、CIMT 0.66 mm分别被确定为T2DM亚临床动脉粥样硬化的有效分界点,敏感性分别为75.8%和92.5%,特异性分别为71.1%和78.2%。结论 T2DM患者EFT、CIMT升高,AVP降低,且EFT、AVP分别与CIMT显著相关,EFT、CIMT可以作为评估T2DM患者亚临床动脉粥样硬化的可靠指标。
Abstract
Objective To find out whether the parameters of epicardial fat thickness (EFT)are associated with aortic velocity propagation (AVP) and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM).Methods Forty-one cases of T2DM who were over 18 years old, left their coronary heart disease undiagnosed but were treated in the Department of Endocrinology and Hematology between November 2019 and June 2020 were selected as the T2DM group,while another 37 non-diabetic patients were enrolled as the control group. EFT and AVP of all these subjects were determined using the echocardiographic method and CIMT was calculated ultrasonographically.Results EFT [(8.41±1.62)mm] and CIMT[(0.93±0.21)mm] in the T2DM group was significantly higher than in the control group [(6.32±2.19)mm, (0.53±0.11)mm],while AVP[ (28.21±16.03)mm] was significantly lower[(58.12±17.49)mm].Correlation analysis showed that EFT was negatively correlated with AVP (r=－0.339, P=0.001), but positively with CIMT (r=0.415, P<0.001). AVP was negatively correlated with CIMT (r=－0.629, P<0.001). Stepwise linear regression analysis showed that CIMT was an independent predictor of EFT(β1=3.255, 95% CI:1.775-4.739, P=0.001) and AVP (β2=－30.868, 95% CI:－45.805-－15.932, P< 0.001). ROC curve analysis showed that EFT 7.2 mm and CIMT 0.66 mm were effective cut-off points of subclinical atherosclerosis in diabetic patients, with a sensitivity of 75.8% and 92.5%, and a specificity of 71.1% and 78.2%, respectively.Conclusions The levels of EFT and CIMT are higher while that of AVP is lower in T2DM patients. EFT and AVP are significantly correlated with CIMT, respectively. EFT and CIMT can be used as reliable indicators for evaluation of subclinical atherosclerosis in T2DM patients.
关键词
超声心动图 /
心外膜脂肪厚度 /
主动脉传播速度 /
颈动脉-内中膜厚度 /
2型糖尿病
Key words
echocardiography /
epicardial fat thickness /
aortic velocity /
carotid intima-media thickness /
type 2 diabetes mellitus
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