2型糖尿病患者胰岛素抵抗代谢评分与心脏重构的相关性
目的:分析2型糖尿病（T2DM）患者胰岛素抵抗代谢评分（METS-IR）与心脏重构的相关性。方法:本研究为横断面研究。回顾性选取2015年4至9月进行的REACTION研究北京分中心随访人群的数据，最终纳入2 495例T2DM患者作为研究对象。收集研究对象的身高、体重（计算体重指数）以及空腹血糖（FPG）、餐后2 h血糖（2hPG）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、γ-谷氨酰转肽酶（GGT）等生化指标，并计算METS-IR。利用彩色多普勒超声仪检测室间隔厚度（IVS）、左心房内径（LAD）、左心室舒张末期内径（LVEDD），以及是否存在舒张功能减退。将研究对象根据METS-...
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| Published in | 中华糖尿病杂志 Vol. 16; no. 7; pp. 755 - 761 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
解放军第三〇五医院内分泌科，北京 100017%解放军总医院第一医学中心内分泌科，北京 100853
20.07.2024
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 1674-5809 |
| DOI | 10.3760/cma.j.cn115791-20240106-00009 |
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| Abstract | 目的:分析2型糖尿病（T2DM）患者胰岛素抵抗代谢评分（METS-IR）与心脏重构的相关性。方法:本研究为横断面研究。回顾性选取2015年4至9月进行的REACTION研究北京分中心随访人群的数据，最终纳入2 495例T2DM患者作为研究对象。收集研究对象的身高、体重（计算体重指数）以及空腹血糖（FPG）、餐后2 h血糖（2hPG）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、γ-谷氨酰转肽酶（GGT）等生化指标，并计算METS-IR。利用彩色多普勒超声仪检测室间隔厚度（IVS）、左心房内径（LAD）、左心室舒张末期内径（LVEDD），以及是否存在舒张功能减退。将研究对象根据METS-IR的四分位数分为
Q1组（METS-IR<34.93，622例），
Q2组（34.93≤METS-IR<39.60，625例），
Q3组（39.60≤METS-IR<44.44，624例）和
Q4组（METS-IR≥44.44，624例）。采用单因素方差分析进行组间比较，采用logistic回归分析法分析METS-IR与心脏重构的关系。
结果:IVS、LAD、LVEDD总体上随着METS-IR的升高而升高（
P<0.001）。METS-IR为IVS增厚、LAD增宽的危险因素，
Q3、
Q4组人群发生IVS增厚的风险分别是
Q1组的1.79倍（95%CI 1.21~2.65，
P=0.004）和2.45倍（95%CI 1.58~3.80，
P<0.001）；
Q2、
Q3、
Q4组人群发生LAD增宽的风险分别是
Q1组人群的2.84倍（95%CI 2.11~3.82，
P<0.001）、4.01倍（95%CI 2.98~5.40，
P<0.001）和6.86倍（95%CI 5.03~9.36，
P<0.001）。METS-IR不是LVEDD增高和舒张功能减退的影响因素（均
P>0.05）。
结论:METS-IR与心脏重构的出现有一定的关系，与IVS增厚及LAD增宽的关系更明显。 |
|---|---|
| AbstractList | 目的:分析2型糖尿病（T2DM）患者胰岛素抵抗代谢评分（METS-IR）与心脏重构的相关性。方法:本研究为横断面研究。回顾性选取2015年4至9月进行的REACTION研究北京分中心随访人群的数据，最终纳入2 495例T2DM患者作为研究对象。收集研究对象的身高、体重（计算体重指数）以及空腹血糖（FPG）、餐后2 h血糖（2hPG）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、γ-谷氨酰转肽酶（GGT）等生化指标，并计算METS-IR。利用彩色多普勒超声仪检测室间隔厚度（IVS）、左心房内径（LAD）、左心室舒张末期内径（LVEDD），以及是否存在舒张功能减退。将研究对象根据METS-IR的四分位数分为
Q1组（METS-IR<34.93，622例），
Q2组（34.93≤METS-IR<39.60，625例），
Q3组（39.60≤METS-IR<44.44，624例）和
Q4组（METS-IR≥44.44，624例）。采用单因素方差分析进行组间比较，采用logistic回归分析法分析METS-IR与心脏重构的关系。
结果:IVS、LAD、LVEDD总体上随着METS-IR的升高而升高（
P<0.001）。METS-IR为IVS增厚、LAD增宽的危险因素，
Q3、
Q4组人群发生IVS增厚的风险分别是
Q1组的1.79倍（95%CI 1.21~2.65，
P=0.004）和2.45倍（95%CI 1.58~3.80，
P<0.001）；
Q2、
Q3、
Q4组人群发生LAD增宽的风险分别是
Q1组人群的2.84倍（95%CI 2.11~3.82，
P<0.001）、4.01倍（95%CI 2.98~5.40，
P<0.001）和6.86倍（95%CI 5.03~9.36，
P<0.001）。METS-IR不是LVEDD增高和舒张功能减退的影响因素（均
P>0.05）。
结论:METS-IR与心脏重构的出现有一定的关系，与IVS增厚及LAD增宽的关系更明显。 |
| Abstract_FL | Objective:To analyze the association between metabolic score for insulin resistance (METS-IR) and cardiac remodeling in patients with type 2 diabetes mellitus (T2DM).Methods:This study was a cross-sectional study that retrospectively selected the follow-up data of Beijing branch of the REACTION study conducted from April 2015 to September 2015, ultimately including a total of 2 495 T2DM patients. Height and weight were collected and body mass index was calculated. Fasting plasma glucose (FPG), 2-hour postprandial glucose (2hPG), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), γ-glutamyl transpeptidase (GGT) were determinded and METS-IR was calculated. Interventricular septal thickness (IVS), left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), and diastolic dysfunction were measured by color Doppler echocardiography. The participants were divided into four groups according to METS-IR quartiles:
Q1 group (METS-IR<34.93, 622 cases),
Q2 group (34.93≤METS-IR<39.60, 625 cases),
Q3 group (39.60≤METS-IR<44.44, 624 cases) and
Q4 group (METS-IR≥44.44, 624 cases). One-way analysis of variance was used for comparison between groups, and logistic regression was applied to explore the association between METI-IR and cardiac remodeling.
Results:IVS, LAD and LVEDD increased with higher METS-IR (
P<0.001), and METS-IR was an independent risk factor for IVS thickening and LAD dilation. Compared with the
Q1 group, the risk of incident IVS thickening was 1.79 times (95%CI 1.21-2.65,
P=0.004) and 2.45 times (95%CI 1.58-3.80,
P<0.001) in
Q3 and
Q4 groups, respectively. Compared with the
Q1 group, the risk of incident LAD widening was 2.84 times (95%CI 2.11-3.82,
P<0.001), 4.01 times (95%CI 2.98-5.40,
P<0.001), and 6.86 times (95%CI 5.03-9.36,
P<0.001) in
Q2,
Q3 and
Q4 groups, respectively. METS-IR was not an independent risk factor for increased LVEDD and reduced diastolic function (both
P>0.05).
Conclusion:METS-IR is associated with cardiac remodeling, particularly IVS thickening and LAD widening. |
| Author | 王安平 曲建昌 窦京涛 谷伟军 母义明 吕朝晖 |
| AuthorAffiliation | 解放军第三〇五医院内分泌科，北京 100017%解放军总医院第一医学中心内分泌科，北京 100853 |
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| Author_FL | Dou Jingtao Lyu Zhaohui Gu Weijun Mu Yiming Wang Anping Qu Jianchang |
| Author_FL_xml | – sequence: 1 fullname: Qu Jianchang – sequence: 2 fullname: Dou Jingtao – sequence: 3 fullname: Wang Anping – sequence: 4 fullname: Gu Weijun – sequence: 5 fullname: Lyu Zhaohui – sequence: 6 fullname: Mu Yiming |
| Author_xml | – sequence: 1 fullname: 曲建昌 – sequence: 2 fullname: 窦京涛 – sequence: 3 fullname: 王安平 – sequence: 4 fullname: 谷伟军 – sequence: 5 fullname: 吕朝晖 – sequence: 6 fullname: 母义明 |
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| Keywords | 胰岛素抵抗代谢评分 糖尿病，2型 Diabetes mellitus, type 2 影响因素 Metabolic score for insulin resistance 横断面研究 Cross-sectional study Cardiac remodeling Influencing factors 心脏重构 |
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| PublicationTitle | 中华糖尿病杂志 |
| PublicationTitle_FL | Chinese Journal of Diabetes Mellitus |
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