|
|
Analysis of influencing factors of atherosclerosis in type 2 diabetes mellitus |
WU Li1 ZHU Hong1 CAO Changchun1 MA Jian2 LI Qian3 YE Meng3 ZHOU Wen1 WANG Shuang1 |
1.Department of Endocrinology, Nanjing Drum Tower Hospital Group Suqian Hospital the Affiliated Suqian Hospital of Xuzhou Medical University, Jiangsu Province, Suqian 223800, China; 2.Department of Ultrasonic Diagnosis, Nanjing Drum Tower Hospital Group Suqian Hospital the Affiliated Suqian Hospital of Xuzhou Medical University, Jiangsu Province, Suqian 223800, China; 3.Department of Clinical Nutrition, Nanjing Drum Tower Hospital Group Suqian Hospital, the Affiliated Suqian Hospital of Xuzhou Medical University, Jiangsu Province, Suqian 223800, China |
|
|
Abstract Objective To explore the influencing factors of arteriosclerosis (AS) in type 2 diabetes mellitus (T2DM) patients. Methods A total of 120 patients with T2DM who were hospitalized in Department of Endocrinology, Nanjing Drum Tower Hospital Group Suqian Hospital from July 2019 to September 2021 were selected, and divided into arteriosclerosis group (60 cases) and non-atherosclerosis group (60 cases) according to the color doppler ultrasound results. The general clinical data of the two groups were compared; and the risk factors of AS were analyzed by logistic regression; receiver operating characteristic (ROC) curve was used to analyse the ability of visceral fat area (VFA) to predict AS risk. Results There were significant differences in age, systolic blood pressure, body mass index, VFA, total cholesterol, triglyceride, low density lipoprotein cholesterol, fasting blood glucose, steady-state model insulin resistance index, diabetic microanglopathy, and hypertension between the two groups (P<0.05). Logistic regression analysis showed that VFA, age and triglyceride were independent risk factors for AS in T2DM patients (P<0.05). ROC curve showed that the area under the curve of VFA in predicting AS in T2DM patients was 0.702, the critical value was 114.7 cm2, the sensitivity was 0.617, and the specificity was 0.733. Conclusion Increased VFA, especially VFA>114.7 cm2 is closely related to the occurrence of AS in T2DM patients.
|
|
|
|
|
[1] Orr JS,Gentile CL,Davy BM,et al. Large artery stiffening with weight gain in humans:role of visceral fat accumulation [J]. Hypertension,2008,51(6):1519-1524. [2] O’ Rourke MF,Safar ME. Relationship between aortic stiffening and microvascular disease in brain and kidney:cause and logic of therapy [J]. Hypertension,2005,46:200-204. [3] 蔡子纯,李纪明.动脉僵硬度增加的发生机制及评估方法的研究进展[J].中国医药导报,2022,19(30):50-53, 57. [4] Kamal AM,Sebak SA,Sanad EF. Mixed Lineage Kinase Domain-Like Pseudokinase (MLKL) Gene Expression in Human Atherosclerosis with and without Type 2 Diabetes Mellitus [J]. Iran Biomed J,2021,25(4):265-274. [5] Niwa H,Takahashi K,Dannoura M,et al. The Association of Cardio-Ankle Vascular Index and Ankle-Brachial Index with Macroangiopathy in Patients with Type 2 Diabetes Mellitus [J]. J Atheroscler Thromb,2019,26(7):616-623. [6] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华内分泌代谢杂志,2021,37(4):311- 398. [7] Liu J,Fan D,Wang X,et al. Association of two novel adiposity indicators with visceral fat area in type 2 diabetic patients: Novel adiposity indexes for type 2 diabetes [J]. Medicine (Baltimore),2020,99(19):e20046. [8] 国家卫生健康委员会脑卒中防治专家委员会血管超声专业委员会,中国超声医学工程学会浅表器官及外周血管超声专业委员会,中国超声医学工程学会颅脑及颈部血管超声专业委员会.头颈部血管超声若干问题的专家共识(颈动脉部分)[J].中国脑血管病杂志,2022,17(6):346-353. [9] 文晓蓉,邢英琦,刘勇,等.腹部及四肢动脉超声若干常见临床问题专家共识[J].中国超声医学杂志,2020,36(12):1057-1066. [10] Fukuda S,Hirata A,Nishizawa H,et al. Systemic arteriosclerosis and eating behavior in Japanese type 2 diabetic patients with visceral fat accumulation [J]. Cardiovasc Diabetol,2015,14:8. [11] Palmer BF,Clegg DJ. The sexual dimorphism of obesity [J]. Mol Cell Endocrinol,2015,402:113-119. [12] Japan Society for the Study of Obesity. Guidelines for the Management of Obesity Disease 2016 [Z]. Life Science Publishing Co., Ltd.; Chuo-ku,Japan:2016. [13] XiaoX,LiuY,SunC,et al. Evaluation of different obesity indices as predictors of type 2 diabetes mellitus in a Chinese population [J]. J Diabetes,2015,7(3):386-392. [14] 林兵,杨勤兵,于永超,等.营养干预对初诊2型糖尿病超重肥胖患者身体成分和血糖的作用[J].中华预防医学杂志,2018,52(12):1276-1280. [15] 中华医学会内分泌学分会.中国2型糖尿病合并肥胖综合管理专家共识[J].中华内分泌代谢杂志,2016,32(8):623-627. [16] Fantuzzi G. Adipose tissue,adipokines,and inflammation [J]. J Allergy Clin Immunol,2005,115:911-919. [17] Wisse BE. The inflammatory syndrome:the role of adipose tissue cytokines in metabolic disorders linked to obesity [J]. J Am Soc Nephrol,2004,15:2792-2800. [18] Boyko EJ,Fujimoto WY,Leonetti DL,et al. Visceral adiposity and risk of type 2 diabetes: a prospective study among Japanese Americans [J]. Diabetes Care,2022,23(4):465-471. [19] Bouchi R,Takeuchi T,Akihisa M,et al. High visceral fat with low subcutaneous fat accumulation as a determinant of atherosclerosis in patients with type 2 diabetes [J]. Cardiovasc Diabetol,2015,14:136. [20] Kurozumi A,Okada Y,Arao T,et al. Excess visceral adipose tissue worsens the vascular endothelial function in patients with type 2 diabetes mellitus [J]. Intern Med,2016, 55:3091-3095. [21] DeNino WF,Tchernof A,Dionne IJ,et al. Contribution of abdominal adiposity to age-related differences in insulin sensitivity and plasma lipids in healthy nonobese women [J]. Diabetes Care,2001,24(5):925-932. [22] Lemieux S,Prud’homme D,Nadeau A,et al. Seven-year changes in body fat and visceral adipose tissue in women. Association with indexes of plasma glucose-insulin homeostasis [J]. Diabetes Care,1996,19(9):983-991. [23] Sogabe M,Okahisa T,Tsujigami K,et al. Visceral fat predominance is associated with non-alcoholic fatty liver disease in Japanese women with metabolic syndrome [J]. Hepatol Res,2014,44:515-522. [24] Tchernof A,Després JP. Pathophysiology of human visceral obesity:an update [J]. Physiol Rev,2013,93(1):359-404. [25] Baek SH,Kim M,Kim M,et al. Metabolites distinguishing visceral fat obesity and atherogenic traits in individuals with overweight [J]. Obesity (Silver Spring),2017,25(2):323- 331. |
|
|
|