2型糖尿病患者血清胆红素水平与颈动脉斑块的相关性

doi:10.3969/j.issn.1004-583X.2021.04.010

摘要/Abstract

摘要：

目的探讨2型糖尿病患者血清胆红素水平与颈动脉斑块形成的相关性。方法选取2型糖尿病住院患者952例,根据颈部血管彩色超声结果存在颈动脉斑块患者426例(有斑块组),无颈动脉斑块患者526例(无斑块组)。记录所有患者基本资料和血清胆红素水平、血糖、血脂、糖化血红蛋白等情况,研究影响颈动脉斑块形成的相关因素。结果与无斑块组相比,有斑块组男性占比更多、年龄更大、病程更长、合并吸烟史及高血压病史更多、总胆红素及间接胆红素水平更低、血肌酐值更高、总胆固醇及低密度脂蛋白胆固醇水平更高(P<0.05)。性别、年龄、病程、吸烟史是发生颈动脉斑块的独立危险因素,间接胆红素为发生颈动脉斑块的保护性因素。结论血清总胆红素水平处于生理范围时,血清间接胆红素水平高低与颈动脉斑块发生风险独立相关。

关键词: 糖尿病, 2型, 胆红素, 颈动脉斑块

Abstract:

Objective To explore the correlation between serum bilirubin level and carotid plaque formation in type 2 diabetes mellitus. Methods Nine hundred and fifty two hospitalized patients with type 2 diabetes were selected, and the patients were divided into 426 patients with carotid plaque (plaque group) and 526 patients without carotid plaque (non-plaque group) according to the results of carotid artery color ultrasonography. The essential information and data including the serum bilirubin level, blood glucose, blood lipids, glycated hemoglobin, etc. were recorded, and related factors affecting the formation of carotid plaque were studied. Results Compared to the patients in non-plaque group, the patients in the plaque group were featured with more males, older age, longer course of disease, longer combined history of smoking and hypertension, lower total bilirubin(TBIL) and indirect bilirubin(IBIL) levels, higher serum creatinine(Scr) and greater total cholesterol(TCHO) and low-density lipoprotein cholesterol(LDL-C) levels(P<0.05). The gender, age, course of disease, smoking history were considered to be independent risk factors of carotid plaque, and indirect bilirubin was considered to be a protective factor for carotid plaque. Conclusion The level of serum indirect bilirubin is independently correlated with the risk of carotid plaque when the serum total bilirubin level is within the physiological range.

Key words: diabetes, type 2, bilirubin, carotid plaque

中图分类号:

R587.1

金晖, 刘尚全. 2型糖尿病患者血清胆红素水平与颈动脉斑块的相关性[J]. 临床荟萃, 2021, 36(4): 340-343.

Jin Hui, Liu Shangquan. Study on correlation between serum bilirubin level and carotid plaque in type 2 diabetes mellitus[J]. Clinical Focus, 2021, 36(4): 340-343.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.04.010

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I4/340

图/表 2

参考文献 29

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项目	斑块组(n=426)	无斑块组(n=526)	统计值(t/Z/χ²)	P值
男/(例)	246(57.7)	257(48.9)	7.460	0.006
年龄(岁)	60(53,66)	54(48,60)	-9.583	<0.01
BMI(kg/m²)	24.19(22.49,26.33)	24.59(22.66,27.02)	-1.701	0.089
病程(月)	84(36,132)	48(12,96)	-5.476	<0.01
吸烟史(例)	152(35.7)	126(24.0)	15.655	<0.01
饮酒史(例)	61(14.3)	54(10.3)	3.641	0.056
糖尿病家族史(例)	165(38.7)	220(41.8)	0.935	0.334
高血压病史(例)	211(49.5)	199(37.8)	13.136	<0.01
ALB(g/L)	42.57±3.32	42.83±3.30	1.179	0.239
TBIL(μmol/L)	12.6(10.5,15.6)	13.5(10.6,16.4)	-2.262	0.024
DBIL(μmol/L)	4.4(3.5,5.5)	4.4(3.4,5.5)	-0.169	0.865
IBIL(μmol/L)	8.4(6.4,10.1)	8.9(6.9,10.9)	-3.018	0.003
ALT(U/L)	21.1(15.1,29.2)	21.0(14.9,31.2)	-0.489	0.625
AST(U/L)	19.3(16.0,24.0)	19.4(16.1,25.3)	-1.151	0.250
Urea(mmol/L)	5.15(4.30,6.22)	4.99(4.30,6.03)	-0.922	0.356
Scr(μmol/L)	62.1(51.7,72.2)	59.0(49.0,70.4)	-2.556	0.011
TG(mmol/L)	1.74(1.21,2.50)	1.81(1.23,2.59)	-0.442	0.658
CHO(mmol/L)	4.94(4.35,5.68)	4.82(4.19,5.51)	-1.973	0.048
LDL-C(mmol/L)	2.88±0.81	2.74±0.79	-2.733	0.006
HDL-C(mmol/L)	1.28(1.05,1.52)	1.28(1.06,1.52)	-0.283	0.777
Hb(g/L)	139.19±15.06	139.43±14.23	0.254	0.799
HbA₁c(%)	8.9(7.4,10.8)	8.9(7.5,10.9)	-0.136	0.891
FPG(mmol/L)	9.45(7.36,12.09)	9.37(7.50,12.39)	-1.157	0.247

项目	斑块组(n=426)	无斑块组(n=526)	统计值(t/Z/χ²)	P值
男/(例)	246(57.7)	257(48.9)	7.460	0.006
年龄(岁)	60(53,66)	54(48,60)	-9.583	<0.01
BMI(kg/m²)	24.19(22.49,26.33)	24.59(22.66,27.02)	-1.701	0.089
病程(月)	84(36,132)	48(12,96)	-5.476	<0.01
吸烟史(例)	152(35.7)	126(24.0)	15.655	<0.01
饮酒史(例)	61(14.3)	54(10.3)	3.641	0.056
糖尿病家族史(例)	165(38.7)	220(41.8)	0.935	0.334
高血压病史(例)	211(49.5)	199(37.8)	13.136	<0.01
ALB(g/L)	42.57±3.32	42.83±3.30	1.179	0.239
TBIL(μmol/L)	12.6(10.5,15.6)	13.5(10.6,16.4)	-2.262	0.024
DBIL(μmol/L)	4.4(3.5,5.5)	4.4(3.4,5.5)	-0.169	0.865
IBIL(μmol/L)	8.4(6.4,10.1)	8.9(6.9,10.9)	-3.018	0.003
ALT(U/L)	21.1(15.1,29.2)	21.0(14.9,31.2)	-0.489	0.625
AST(U/L)	19.3(16.0,24.0)	19.4(16.1,25.3)	-1.151	0.250
Urea(mmol/L)	5.15(4.30,6.22)	4.99(4.30,6.03)	-0.922	0.356
Scr(μmol/L)	62.1(51.7,72.2)	59.0(49.0,70.4)	-2.556	0.011
TG(mmol/L)	1.74(1.21,2.50)	1.81(1.23,2.59)	-0.442	0.658
CHO(mmol/L)	4.94(4.35,5.68)	4.82(4.19,5.51)	-1.973	0.048
LDL-C(mmol/L)	2.88±0.81	2.74±0.79	-2.733	0.006
HDL-C(mmol/L)	1.28(1.05,1.52)	1.28(1.06,1.52)	-0.283	0.777
Hb(g/L)	139.19±15.06	139.43±14.23	0.254	0.799
HbA₁c(%)	8.9(7.4,10.8)	8.9(7.5,10.9)	-0.136	0.891
FPG(mmol/L)	9.45(7.36,12.09)	9.37(7.50,12.39)	-1.157	0.247

变量	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
变量	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
男性	0.418	0.176	5.646	0.017	1.519	1.076	2.145
年龄(岁)	0.085	0.009	84.045	0.000	1.089	1.069	1.108
病程(月)	0.003	0.001	8.264	0.004	1.003	1.001	1.006
有吸烟史	0.626	0.192	10.670	0.001	1.870	1.285	2.723
IBIL(μmol/L)	-0.081	0.026	9.495	0.002	0.922	0.876	0.971

变量	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
变量	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
男性	0.418	0.176	5.646	0.017	1.519	1.076	2.145
年龄(岁)	0.085	0.009	84.045	0.000	1.089	1.069	1.108
病程(月)	0.003	0.001	8.264	0.004	1.003	1.001	1.006
有吸烟史	0.626	0.192	10.670	0.001	1.870	1.285	2.723
IBIL(μmol/L)	-0.081	0.026	9.495	0.002	0.922	0.876	0.971