糖调节受损和糖尿病患者的动脉僵硬度与10年心血管疾病风险评估

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摘要目的: 探讨不同糖代谢状态患者血管僵硬度与基线资料的相关性，及其对10年心血管疾病发病风险的预测价值。方法: 入选研究对象105例，其中正常对照组47例，糖调节受损组32例，糖尿病组26例，收集患者基本资料、总胆固醇、LDL-C、三酰甘油、HDL-C、空腹血糖、空腹胰岛素(fasting insulin，FIN)、空腹C肽(fasting C-peptide，Cp)、HbA1c、颈股脉搏波传导速度（carotid-to-femoral pulse wave velocity，cfPWV）、颈桡脉搏波传导速度 (carotid-to-radial pulse wave velocity , cr-PWV)，行糖耐量试验( oral glucose tolerance test, OGTT) 2 h后测血糖（2hPG)；结合相关指标计算Framingham 10年心血管病风险(Framingham risk score，FRS)。结果： cf-PWV与糖调节受损情况、年龄、收缩压、2hPG正相关，与 FIN/Cp负相关；cr-PWV与性别相关，与HDL-C负相关。cf-PWV与cr-PWV之间也存在正相关,且在校正年龄、收缩压、HDLC因素后，仍相关。FRS与cf-PWV、FIN/Cp、Homa-IR(Cp)存在相关性，与cr-PWV则无明显相关性。结论： cf-PWV与FRS存在相关性，可作为评估患者10年心血管疾病发生风险的参考指标。

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关键词 ：动脉僵硬度, 脉搏波传导速度, 胰岛素抵抗, 空腹C肽, Framingham风险评分

Abstract：Objective: To investigate the relationship between different glucose metabolism status and pulse wave velocity(PWV)，and to further explore PWV with the Framingham risk score(FRS) of 10-year as predictors of cardiovascular disease(CVD). Methods: A total of 105 subjects were divided into three groups：normal glucose tolerance group(G1,n=47);prediabetes group(G2,n=32)，and type 2 diabetes mellitus group(G3，n=26)．General clinical data of subjects in each group were collected，and biochemical parameters were measured.PWV was measured using the Complior SP(pulse wave velocity determinator).FRS was calculated with the lipids excel spreadsheets from Framingham Heart Study homepage.The correlation of different glucose metabolism status ,PWV and FRS in different groups was analyzed and compared. Results: A positive correlation was found between carotid-to-femoral pulse wave velocity(cf-PWV) and impaired glucose regulation,age,SBP，2hPG, carotid-to-radial pulse wave velocity （cr-PWV）.A negative correlation was also evident between cf-PWV and fasting insulin /fasting C-peptide(FIN/Cp). A correlation was found between cr-PWV and sex, or HDL-C(negative). A correlation was also found between FRS and cf-PWV，or FIN/Cp，or Homa-IR(Cp). Conclusion: cf-PWV has a good clinical value as a vascular structure and function indicator for evaluating the 10year risk of CVD.

收稿日期: 2014-01-23

通讯作者: 付强（通讯作者），教授，主任医师，硕士研究生导师，Email: fuqiang@medmail.com.cn

作者简介: 张倩(1987—)，女，硕士研究生

引用本文:

张倩1，付强2，魏鹏2，钟健1，朱可2. 糖调节受损和糖尿病患者的动脉僵硬度与10年心血管疾病风险评估[J]. 江苏大学学报:医学版, 2014, 24(02): 145-148,152. ZHANG Qian1，FU Qiang2，WEI Peng2，ZHONG Jian1，ZHU Ke2. Association between pulse wave velocity and the Framingham risk score in patients with different glucose metabolism status. Journal of Jiangsu University(Medicine Edition), 2014, 24(02): 145-148,152.

链接本文:

http://zzs.ujs.edu.cn/xbyxb/CN/ 或 http://zzs.ujs.edu.cn/xbyxb/CN/Y2014/V24/I02/145

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