广州医科大学学报

目的:探讨血清总胆固醇与高密度脂蛋白胆固醇比值(TC/HDL-C)及踝肱指数(ABI)与糖尿病下肢血管病变(PAD)相关性。方法:回顾性分析2012年1月至2014年1月收治的95例T2DM患者的临床资料,采用多普勒血流探测仪检测患者ABI,根据ABI结果分为PAD组(≤0.9,38例)和非PAD组(>0.9,57例)。比较两组患者年龄、性别、病程、吸烟状态、血压、腰臀比(WHR)和体重指数(BMI)、空腹(FPG)及餐后2 h血糖(PPG)、空腹胰岛素(INS)、C肽(C-P)、TC、TG、HDL、LDL、糖化血红蛋白(HbA1c)、尿酸(UA)、血清胱抑素C(CysC)、血清β2微球蛋白(β2-MG)。结果:两组患者的年龄、吸烟者比例、INS、TC/HDL-C比值比较,差异有统计学意义(P<0.05)。PAD组病程、WHR、BMI、HbA1c、SBP、HDL、CYSC、FPG、C-P、TC、TG、LDL、UA、β2-MG比较,差异无统计学意义(P>0.05)。结论:血清TC/HDL-C比值和ABI是预测PAD的独立危险因素,血清TC/HDL-C比值较单项血脂检测更具敏感性,PAD与增龄、TC/HDL-C,空腹INS水平、吸烟状态具有相关性。

Objective:To investigate the correlation between the serum total cholesterol and high densitylipoprotein cholesterol(TC/ HDL-C) and ankle brachial index( ABI) and diabetic peripheral arterial disease(PAD).Methods: Clinical data of 95 patients with type 2 diabetes mellitus(T2DM) admitted from January2012 to January 2014 in our hospital were retrospectively analyzed. The ABI of patients were detected by Dopplerblood flow survey meter, and patients were divided into PAD group(≤0.9, 38 cases) and non-PAD group(>0.9, 57 cases) according to ABI results. Age, sex, course of disease, smoking status, blood pressure, waist-to-hipratio(WHR), body mass index(BMI), fasting plasma glucose(FPG) and 2h postchallenge plasma glucose(PPG), fasting insulin(INS), C peptide(C-P), TC, TG, HDL, LDL, glycosylated hemoglobin(HbA1c),uric acid(UA), serum cystatin C(CysC), serum β2 microglobulin(β2-MG) were compared between the twogroups.Results: The two groups had statistical significance on age, smoker percentage, INS and TC/ HDL-Cratio(P<0.05). There was no significant difference of course of disease, WHR, BMI, HbA1 c, SBP, HDL,CYSC, FPG, C-P, TC, TG, LDL, UA, β2-MG in PAD group(P>0.05).Conclusion: Serum TC/ HDL-C ratioand ABI are independent risk factors for predicting PAD. Serum TC/ HDL-C ratio is more sensitive than theindividual lipid detection. There are correlations between PAD and age, TC/ HDL-C, fasting INS levels andsmoking status.