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多囊卵巢综合征与 1 型糖尿病正常体重女性亚临床血管疾病风险的关系。

Association between polycystic ovary syndrome and the risk of subclinical vascular disease in normal‑weight women with type 1 diabetes.

出版信息

Pol Arch Intern Med. 2017 Nov 30;127(11):741-748. doi: 10.20452/pamw.4116. Epub 2017 Sep 30.

Abstract

INTRODUCTION    The prevalence of polycystic ovary syndrome (PCOS) among women with type 1 diabetes (T1DM) is higher than in the general population. Both diseases are associated with higher risk of premature atherosclerosis. OBJECTIVES    The aim of our study was to evaluate whether the cardiovascular risks conferred by T1DM and PCOS are additive. PATIENTS AND METHODS   The study group included 78 women divided into 4 groups: 19 women with PCOS and T1DM (T1DM+PCOS), 16 women with T1DM only (T1DM/no‑PCOS), 27 women with PCOS only(PCOS), and 16 healthy women (control group). We evaluated the serum concentrations of cardiovascular disease biomarkers: soluble intercellular adhesion molecule 1 (sICAM‑1) and soluble endothelial‑leukocyte adhesion molecule 1 (sE‑selectin). We also assessed brachial artery flow‑mediated dilation (FMD) and estimated the intima-media thickness of the common carotid artery (CIMT) by ultrasonography. RESULTS    The serum concentrations of sICAM‑1and sE‑selectin were higher in the T1DM+PCOS group compared with women with PCOS only (P = 0.041 and P = 0.002, respectively) and were comparable to those in the T1DM/no‑PCOS group. FMD and CIMT did not differ between the groups. In women with T1DM, sICAM‑1 positively correlated with body mass index (r = 0.34, P = 0.047), CIMT with daily insulin dose (r = 0.37, P = 0.039), and FMD negatively correlated with diabetes duration (r = -0.42, P = 0.02). In a multivariable logistic regression model, the presence of T1DM, with adjustment for sICAM‑1, was the only predictor of sE‑selectin concentrations in the whole study group (odds ratio, 8.03; 95% confidence interval, 2.56-13.49; P = 0.005). CONCLUSIONS    The presence of PCOS does not increase the risk of subclinical vascular disease in young lean women with T1DM.

摘要

简介多囊卵巢综合征(PCOS)在 1 型糖尿病(T1DM)女性中的患病率高于普通人群。这两种疾病都与早发动脉粥样硬化的风险增加有关。目的我们研究的目的是评估 T1DM 和 PCOS 带来的心血管风险是否具有累加性。患者与方法研究组包括 78 名女性,分为 4 组:19 名患有 PCOS 和 T1DM(T1DM+PCOS)的女性、16 名仅患有 T1DM(T1DM 无 PCOS)的女性、27 名仅患有 PCOS 的女性和 16 名健康女性(对照组)。我们评估了心血管疾病生物标志物的血清浓度:可溶性细胞间黏附分子 1(sICAM-1)和可溶性内皮白细胞黏附分子 1(sE-选择素)。我们还通过超声评估了肱动脉血流介导的扩张(FMD)并估计了颈总动脉内膜中层厚度(CIMT)。结果与仅患有 PCOS 的女性相比,T1DM+PCOS 组的血清 sICAM-1 和 sE-选择素浓度更高(P=0.041 和 P=0.002),与 T1DM 无 PCOS 组相当。各组间 FMD 和 CIMT 无差异。在患有 T1DM 的女性中,sICAM-1 与体重指数呈正相关(r=0.34,P=0.047),CIMT 与每日胰岛素剂量呈正相关(r=0.37,P=0.039),FMD 与糖尿病病程呈负相关(r=-0.42,P=0.02)。在多变量逻辑回归模型中,存在 T1DM,调整 sICAM-1 后,是整个研究组 sE-选择素浓度的唯一预测因子(比值比,8.03;95%置信区间,2.56-13.49;P=0.005)。结论在年轻瘦的患有 T1DM 的女性中,存在 PCOS 并不会增加亚临床血管疾病的风险。

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