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[老年糖尿病患者高脂血症与下肢动脉疾病的关系]

[The relationship between hyperlipidemia and lower limb arterial disease in elderly diabetes patients].

作者信息

Chen Xiu-Hua, Lu Zhao-Lin, Guo Fa-Jin, Tang Zhi-Yi

机构信息

Department of Diagnostic Ultrasound, Beijing Hospital, Ministry of Health, Beijing 100730, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2008 Jul;47(7):556-9.

Abstract

OBJECTIVE

To evaluate the correlation between hyperlipidemia and lower limb arterial disease in elderly diabetic patients with color Doppler ultrasonography.

METHODS

Two hundred and sixty elderly diabetic patients and 206 normal subjects were enrolled in the study. Doppler ultrasonographic manifestations of lower limb arterial disease, blood pressure and blood biochemistry parameters including fasting plasma glucose (FPG), postprandial plasma glucose (PPG), TC, TG, HLD-C, LDL-C, apoprotein B (apoB), very low density lipoprotein cholesterol (VLDL-C), apoprotein A1 (apoA1) and fibrinogen (Fb) were compared between the 2 groups.

RESULTS

(1) The blood biochemistry parameters, including the levels of FPG, PPG, TC, TG, VLDL-C, LDL-C, apoB and Fb were higher in diabetic patients than in normal subjects, while HDL-C was lower (all P < 0.05). (2) The thickness of intima-media (IMT) in the lower limb arterial disease group was significantly increased and the presence of arterial stenosis and wall plaques more in diabetic patients [IMT in 205 cases (78.85%), atherosclerotic plaque in 241 cases (92.69%), multivessel disease (more than 2 vessels) in 60 cases (23.08%) and arterial stenosis in 89 cases (34.23%)] than in normal subjects [IMT in 37 cases (17.96%), atherosclerotic plaque in 51 cases (24.76%), multivessel disease in 27 cases (13.11%) and arterial stenosis in 3 cases (0.01%)], all P < 0.01. (3) Regression analysis showed that lower limb arterial disease was correlated with high level of LDL-C and low level of HDL-C.

CONCLUSIONS

Arteriosclerotic plaque is one of the early manifestations in elderly diabetic patients and hyperlipidemia may provide the basis of its formation. Doppler ultrasonographic examination of lower limbarterial discloses the early arteriosclerotic changes of lower limb arterial disease in elderly patients and offers the basic data of indication for clinical treatment.

摘要

目的

采用彩色多普勒超声评估老年糖尿病患者高脂血症与下肢动脉疾病之间的相关性。

方法

本研究纳入了260例老年糖尿病患者和206例正常受试者。比较两组下肢动脉疾病的多普勒超声表现、血压以及血液生化参数,包括空腹血糖(FPG)、餐后血糖(PPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apoB)、极低密度脂蛋白胆固醇(VLDL-C)、载脂蛋白A1(apoA1)和纤维蛋白原(Fb)。

结果

(1)糖尿病患者的血液生化参数,包括FPG、PPG、TC、TG、VLDL-C、LDL-C、apoB和Fb水平均高于正常受试者,而HDL-C水平较低(均P<0.05)。(2)下肢动脉疾病组的内膜中层厚度(IMT)显著增加,糖尿病患者中动脉狭窄和管壁斑块的发生率更高[205例(78.85%)存在IMT增厚,241例(92.69%)存在动脉粥样硬化斑块,60例(23.08%)存在多支血管病变(超过2支血管),89例(34.23%)存在动脉狭窄],高于正常受试者[37例(17.96%)存在IMT增厚,51例(24.76%)存在动脉粥样硬化斑块,27例(13.11%)存在多支血管病变,3例(0.01%)存在动脉狭窄],均P<0.01。(3)回归分析显示,下肢动脉疾病与LDL-C高水平和HDL-C低水平相关。

结论

动脉粥样硬化斑块是老年糖尿病患者的早期表现之一,高脂血症可能为其形成提供基础。下肢动脉的多普勒超声检查可揭示老年患者下肢动脉疾病的早期动脉硬化改变,并为临床治疗提供指示的基础数据。

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