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目的探讨2型糖尿病与桡动脉反射波增强指数的关系,为预防动脉粥样硬化性心脑血管疾病(ASCVD)的发生提供依据。方法于2012年采用横断面研究设计,对北京市首钢社区居民进行问卷调查、体格检查、血糖及血脂等生化指标检测,并进行桡动脉反射波增强指数(rAI)检查,通过数学转换获得心率为75次/min时的桡动脉反射波增强指数标准校正值(rAI_(P75))。分析在无ASCVD证据的调查对象中2型糖尿病与rAI_(P75)之间的关系。结果共纳入6 946例研究对象,平均年龄为(55.90±8.63)岁,其中2 475例(35.63%)为男性,2型糖尿病患者1 550例(22.32%)。rAI_(P75)的±s为(80.29±11.90)%。相对于非糖尿病人群[(80.25±11.92)%],2型糖尿病人群具有高的rAI_(P75)水平[(80.46±11.84)%],但差异不具有统计学意义(β=0.214 0,P=0.532 7)。在对年龄、性别、体质指数(BMI)、教育程度、吸烟、饮酒、体育锻炼情况、高血压、高脂血症因素进行控制后,2型糖尿病患者rAI_(P75)升高显著(2型糖尿病患者与非糖尿病患者比较:β=0.757 6,P=0.018 7)。在亚组分析中,在男性、年轻组、无高血压组和现在不吸烟组中得到类似的结果。结论本次调查的无ASCVD证据的社区居民中2型糖尿病与rAI存在相关关系,2型糖尿病组的rAI水平显著升高,且主要体现在男性及低危(年龄小于55岁、无高血压、不吸烟)人群中。这提示在男性及低危的2型糖尿病患者中更应定期监测rAI,关注ASCVD的进展。
Objective To investigate the relationship between type 2 diabetes mellitus (T2DM) and the index of radial artery reflex enhancement and provide the basis for the prevention of atherosclerotic cardiovascular and cerebrovascular diseases (ASCVD). Methods In 2012, a cross-sectional study design was used to investigate the biochemical indexes such as questionnaire, physical examination, blood glucose and blood lipid in residents of Beijing Shougang Group and to examine the radial artery reflex enhancement index (rAI). The heart rate was Radial Artery Reflex Enhancement Index Standard Correction (rAI_ (P75)) at 75 beats / min. To analyze the relationship between type 2 diabetes and rAI_ (P75) in subjects without ASCVD evidence. Results A total of 6 946 subjects were enrolled. The mean age was (55.90 ± 8.63) years. Of these, 2475 (35.63%) were male and 1550 (22.32%) were patients with type 2 diabetes. The ± s of rAI_ (P75) was (80.29 ± 11.90)%. Compared with non-diabetic patients [(80.25 ± 11.92)%], patients with type 2 diabetes had high rAI P75 levels [(80.46 ± 11.84)%], but the difference was not statistically significant (β = 0.214 0, P = 0.532 7). Patients with type 2 diabetes developed significantly more rAI_ (P75) after controlling for factors such as age, gender, body mass index (BMI), education, smoking, drinking, physical activity, hypertension, and hyperlipidemia Patients compared with non-diabetic patients: β = 0.757 6, P = 0.018 7). In a subgroup analysis, similar results were obtained in the male, young, non-hypertensive and non-smoking groups. Conclusions There is a relationship between type 2 diabetes and rAI in community residents without evidence of ASCVD in this survey. The rAI level in type 2 diabetes patients is significantly elevated, mainly in men and at low risk (age less than 55 years, no hypertension, Not smoking) in the crowd. This suggests that rAI should be monitored regularly in both male and low-risk type 2 diabetic patients, focusing on ASCVD progression.