| 综合动脉粥样硬化指标评估糖尿病心血管风险 |
| 投稿时间：2024-11-09 修订日期：2024-12-11 点此下载全文 |
| 引用本文：徐静,于嘉昊,董振华,李彬.综合动脉粥样硬化指标评估糖尿病心血管风险[J].医学研究杂志,2025,54(5):29-33 |
| DOI：
10.11969/j.issn.1673-548X.2025.05.007 |
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| 基金项目:国家自然科学基金资助项目(面上项目)(82470397)；中国博士后科学基金资助项目(2020M682119)；山东省自然科学基金资助项目(ZR2020MH026)；山东省博士后创新项目(202102041) |
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| 中文摘要:目的 探讨血浆致动脉粥样硬化指数(atherogenic index of plasma,AIP)、颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)和肱踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)指标与2型糖尿病(type 2diabetes mellitus,T2DM)患者未来10年动脉粥样硬化性心血管病(atherosclerotic cardiovascular disease,ASCVD)风险的相关性。方法 回顾性分析了2020年1月~2022年12月在山东第一医科大学附属中心医院进入国家标准化代谢性疾病管理中心(National Metabolic Management Center, MMC)管理的并接受AIP、CIMT和baPWV测量的131例2型糖尿病患者的临床资料。基于China-PAR(prediction for ASCVD risk in China)模型计算所有患者未来10年ASCVD发病风险,并将其分为低中危组和高危组。采用单因素分析筛选与心血管风险相关的变量,并通过多因素Logistic回归分析评估AIP、CIMT和baPWV对ASCVD发病风险的独立影响,应用Hosmer-Lemeshow拟合优度检验评估组合变量(AIP、CIMT和baPWV)的适配性。最后采用受试者工作特征曲线和DeLong检验对组合变量以及单一变量的预测效能进行评估。结果 多因素Logisitic回归分析结果显示,AIP、CIMT和baPWV是2型糖尿病患者ASCVD发病风险的独立危险因素(OR>1,P<0.05)。Hosemer-Lemeshow拟合优度检验:χ2=2.725,P=0.950。AIP、CIMT和baPWV的组合变量在预测2型糖尿病患者ASCVD发病风险方面表现出更高的分类效能(AUC=0.834),显著高于单一变量。结论 AIP、CIMT和baPWV在评估2型糖尿病患者ASCVD发病风险中具有重要临床价值。通过整合这些指标的组合分析显示出较好的预测性能,可为2型糖尿病患者的个体化心血管风险评估提供有效工具。 |
| 中文关键词:2型糖尿病 血浆致动脉粥样硬化指数 颈动脉内膜中层厚度 肱踝脉搏波传导速度 心血管风险 |
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| Comprehensive Assessment of Cardiovascular Risk in Diabetes Using Atherosclerosis Indicators |
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| Abstract:Objective To investigate the relationship between the atherogenic index of plasma (AIP), carotid intima-media thickness (CIMT), and brachial-ankle pulse wave velocity (baPWV) with the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) in patients with type 2diabetes mellitus (T2DM).Methods This study retrospectively analyzed the clinical data of 131 T2DM patients managed through the National Metabolism Management Center (MMC) at the Affiliated Central Hospital of Shandong First Medical University from January 2020 to December 2022, all of whom had undergone AIP, CIMT and baPWV assessments.The 10-year ASCVD risk for each patient was estimated using the China-PAR model, classifying patients into low-to-moderate and high-risk groups. Univariate analysis was employed to identify variables correlated with cardiovascular risk, followed by multivariate Logistic regression analysis to evaluate the independent impact of AIP, CIMT and baPWV on ASCVD risk. The Hosmer-Lemeshow goodness-of-fit test was used to assess the suitability of the combined variables (AIP, CIMT and baPWV). Lastly, the predictive efficacy of the combined variables and individual indicators was assessed using receiver operating characteristic (ROC) curves and the DeLong test.Results Multivariate Logistic regression analysis demonstrated that AIP, CIMT and baPWV were independent risk factors for ASCVD in T2DM patients(OR>1,P<0.05). The Hosmer-Lemeshow goodness-of-fit test indicated satisfactory model fit (χ2=2.725, P=0.950). The combined variable of AIP, CIMT and baPWV exhibited superior discriminative ability in predicting ASCVD risk among T2DM patients(AUC=0.834), significantly outperforming individual variables.Conclusion AIP, CIMT and baPWV have significant clinical value in assessing ASCVD risk in T2DM patients. Integrating these indicators enhances predictive performance, offering an effective tool for individualized cardiovascular risk assessment in T2DM patients. |
| keywords:Type 2diabetes mellitus Atherogenic index of plasma Carotid intima-media thickness Brachial-ankle pulse wave velocity Cardiovascular risk |
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