摘要
目的 探讨内脏脂肪面积(VFA)对2型糖尿病(T2DM)患者合并颈动脉粥样硬化斑块的影响.方法 筛选2018年8月至2023年8月期间南京医科大学附属老年医院内分泌科纳入国家标准化代谢性疾病管理中心数据库的T2DM者683例,对研究对象进行病史、体格检查、血清生化指标以及VFA等资料的收集,按照有无合并颈动脉粥样硬化斑块分为T2DM合并斑块组(n=342)及T2DM无斑块组(n=341),并进行相关统计学分析.结果 年龄、身体质量指数(BMI)、腰围、舒张压(DBP)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、腹部皮下脂肪面积(SFA)及VFA等水平在两组间比较差异均有统计学意义(P＜0.05).Logistic 多元逐步回归分析结果显示,年龄大(OR=1.070,95％CI:1.050-1.091)、VFA水平高(OR=1.020,95％CI:1.012-1.028)是T2DM患者颈动脉粥样斑块形成的危险因素(P＜0.01).VFA及BMI、腰围、腹部SFA对T2DM动脉粥样硬化预测的曲线下面积(AUC)分别为0.673、0.590、0.621和0.601,以VFA最高.当VFA临界值为85 cm2时,其敏感度及特异度分别为95.3％、61.6％.结论 年龄和VFA是T2DM患者动脉粥样硬化斑块形成的独立影响因素,VFA作为新型的肥胖评估指标能够更好的预测并评估T2DM患者动脉粥样硬化斑块发生的风险.
Abstract
Objective To investigate the effect of visceral fat area(VFA)on carotid atherosclerotic plaque in patients with type 2 diabetes mellitus(T2DM).Methods From August 2018 to August 2023,683 T2DM patients included in the database of the National Metabolic Management Center(MMC)were selected from the Department of Endocrinology,the Affiliated Geriatric Hospital of Nanjing Medical University.Medical history,physical examination,serum biochemical indicators,VFA and other data were collected from the study subjects.According to the presence or absence of carotid atherosclerotic plaque,all patients were divided into T2DM patients with plaque(n=342)and T2DM patients without plaque(n=341),and statistical analysis was performed.Results There were statistically significant differences in age,body mass index(BMI),waist circumference,diastolic blood pressure(DBP),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),abdominal subcutaneous fat area(SFA)and VFA between the two groups(P＜0.05).Multivariate logistic stepwise regression analysis showed that older age(OR=1.070,95％CI:1.050-1.091)and higher level of VFA(OR=1.020,95％CI:1.012-1.028)were the risk factors for the formation of carotid atherosclerotic plaque in T2DM patients(P＜0.01).The area under the curve(AUCs)of VFA,BMI,waist circumference,and abdominal SFA for predicting atherosclerosis in T2DM were 0.673,0.590,0.621,and 0.601,respectively,with VFA being the highest.When the critical value of VFA was 85 cm2,its sensitivity and specificity were 95.3％and 61.6％,respectively.Conclusion Age and VFA are independent influencing factors for atherosclerotic plaque formation in patients with T2DM,and as a new obesity assessment index,VFA can better predict and assess the risk of atherosclerotic plaque formation in T2DM patients.
基金项目
江苏省重点研发计划社会发展项目(BE2023774)
NETL
NSTL
万方数据