摘要
目的 探讨甘油三酯-葡萄糖(TyG)指数、尿酸/高密度脂蛋白胆固醇比值(UHR)、血小板/淋巴细胞比值(PLR)与2型糖尿病(T2DM)患者颈动脉粥样硬化的关联.方法 选取浙江中医药大学附属第二医院2021年4月至2023年4月确诊的65例T2DM且经颈部超声检查伴有颈动脉粥样硬化形成的患者作为观察组,另外按照病例配对研究原则选取65例确诊T2DM但颈动脉未发生粥样硬化患者为对照组;对比两组的一般资料、血脂血糖代谢、肾功能指标及TyG指数、UHR、PLR测定值,分析各项因素与T2DM患者产生颈动脉粥样硬化的相关性,TyG指数、UHR、PLR测定值对T2DM患者发生颈动脉粥样硬化的预测价值分析采用受试者工作特征曲线(ROC)模型.结果 TyG指数、UHR、PLR测定值观察组患者高于对照组,统计学对比差异显著(P＜0.01);甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血尿素氮、血清肌酐、颈动脉内膜中层厚度测定值进行对比分析,观察组高于对照组,统计学对比差异显著(P＜0.01);高密度脂蛋白胆固醇(HDL-C)测定值观察组低于对照组,统计学对比差异显著(P＜0.01).TyG指数、UHR、PLR、TG、LDL-C增高以及HDL-C降低是T2DM患者发生颈动脉粥样硬化的独立危险因素(P＜0.05);TyG指数、UHR、PLR及联合预测T2DM患者发生颈动脉粥样硬化的ROC曲线下面积分别为0.679、0.721、0.732、0.947.结论 TyG指数、UHR、PLR三项指标联合应用预测T2DM患者发生颈动脉粥样硬化具有较高的灵敏度,并且与患者发生颈动脉粥样硬化关系密切.
Abstract
Objective To explore the relationship between triglyceride-glucose(TyG)index,uric acid to high-density lipoprotein cholesterol ratio(UHR),platelet to lymphocyte ratio(PLR)and carotid atherosclerosis in patients with type 2 diabetes mellitus(T2DM).Methods Sixty-five patients with T2DM and carotid atherosclerosis confirmed by neck ultrasonography at the Second Affiliated Hospital of Zhejiang Chinese Medical University from April 2021 to April 2023 were selected as the observation group.Additionally,65 patients with confirmed T2DM but without carotid atherosclerosis were selected as the control group according to the principle of case-control study.The general information,lipid and glucose metabolism,renal function indicators,as well as the measured values of TyG index,UHR,and PLR were compared between the two groups to analyze the correlation between various factors and the occurrence of carotid atherosclerosis in patients with T2DM.The predictive value of the measured values of TyG index,UHR,and PLR for the occurrence of carotid atherosclerosis in patients with T2DM was analyzed using receiver operating characteristic curve(ROC)model.Results The measured values of TyG index,UHR,and PLR in the observation group were higher than those in the control group,and the statistical comparison showed significant differences(P＜0.01).The measured values of triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),blood urea nitrogen,serum creatinine,and carotid intima-media thickness in the observation group were higher than those in the control group,and the statistical comparison showed significant differences(P＜0.01).The measured value of high-density lipoprotein cholesterol(HDL-C)in the observation group was lower than that in the control group,and the statistical comparison showed significant differences(P＜0.01).Increased TyG index,UHR,PLR,TG,and LDL-C,and decreased HDL-C in patients with T2DM were independent risk factors for the occurrence of carotid atherosclerosis(P＜0.05).The areas under the ROC curve of TyG index,UHR,PLR,and combined prediction for the occurrence of carotid atherosclerosis in patients with T2DM were 0.679,0.721,0.732,and 0.947,respectively.Conclusion The combined application of TyG index,UHR,and PLR exhibits high sensitivity in predicting the occurrence of carotid atherosclerosis in T2DM patients and is closely related to the occurrence of carotid atherosclerosis in patients.
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