血清胰高血糖素样肽-1水平可预测新诊断2型糖尿病患者的颈动脉粥样硬化

周华.血清胰高血糖素样肽-1水平可预测新诊断2型糖尿病患者的颈动脉粥样硬化[J].内科急危重症杂志,2022,28(3):200-203

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DOI：10.11768/nkjwzzzz20220306

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作者	单位	E-mail
周华	郴州市第一人民医院	Zhouhua211@163.com

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中文摘要:

目的：探讨新诊断2型糖尿病（T2DM）患者血清胰高血糖素样肽-1（GLP-1）水平与颈动脉粥样硬化（CAS）的相关性。方法：选择T2DM患者180例，均接受颈动脉超声检查，分为单纯T2DM组（78例）和T2DM合并CAS组（DMCAS 组，102例），另选取本院同期健康体检者60例为对照组，比较3组临床检查指标；多因素 logistic 回归分析T2DM患者并发CAS的独立影响因素，将DMCAS 组患者根据CAS分级分为1、2、3级，比较不同分级的空腹血糖（FPG）、低密度脂蛋白胆固醇(LDL)、GLP-1 和颈动脉内中膜厚度(IMT)水平。统计学分析GLP-1与CAS分级、FPG、LDL和IMT的相关性。受试者工作特征（ROC）曲线分析GLP-1对T2DM合并CAS发生的预测价值。结果：FPG、LDL、GLP-1和IMT为T2DM患者合并CAS的独立危险因素（P均<0.05）。GLP-1与CAS分级、FPG、LDL和IMT呈显著负相关（P均<0.05）。预测T2DM患者CAS发生的最佳GLP-1水平为6.59 pmol/L（P<0.05）。结论：T2DM合并CAS患者血清GLP-1水平明显降低，且与CAS严重程度相关；GLP-1水平能在一定程度上预测T2DM患者CAS的发生。

英文摘要:

Objective: To investigate the relationship between serum glucagon-like peptide-1 (GLP-1) level and carotid atherosclerosis (CAS) in newly diagnosed type 2 diabetes mellitus (T2DM). Methods: A total of 180 T2DM patients underwent carotid artery ultrasound examination, and divided into T2DM group (n=78) and T2DM combined with CAS group (n=102). A total of 60 healthy subjects in our hospital at the same time were selected as the control group, and the clinical examination indexes of the three groups were compared. Multivariate logistic regression analysis was conducted to analyze the independent influencing factors of T2DM patients with CAS, and the DMCAS group was divided into grade 1, grade 2 and grade 3 according to the CAS classification. Fasting blood glucose (FPG), low density lipoprotein cholesterol (LDL), GLP-1 and carotid intima-media thickness (IMT) levels were compared among different grades. The correlation between GLP-1 and CAS grade, FPG, LDL and IMT was analyzed statistically. The predictive value of GLP-1 in T2DM with CAS was analyzed by receiver operating characteristic (ROC) curve. Results: FPG, LDL, GLP-1 and IMT were independent risk factors for CAS in T2DM patients (all P<0.05). GLP-1 was significantly negatively correlated with CAS grade, FPG, LDL and IMT (all P<0.05). The optimal GLP-1 level to predict the occurrence of CAS in T2DM patients was 6.59pmol/L (P<0.05). Conclusions: Serum GLP-1 level in T2DM patients with CAS is significantly decreased, and is related to the severity of CAS. GLP-1 level can predict the occurrence of CAS in T2DM patients to a certain extent.