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适量饮酒与 2 型糖尿病患者颈动脉内膜中层厚度

Moderate alcohol consumption and carotid intima-media thickness in type 2 diabetes.

机构信息

Department of endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China.

Department of endocrinology, Zhoushan Hospital, Zhejiang, China.

出版信息

Asia Pac J Clin Nutr. 2021 Sep;30(3):497-503. doi: 10.6133/apjcn.202109_30(3).0016.

Abstract

BACKGROUND AND OBJECTIVES

Carotid intima-media thickness (IMT) is a risk predictor for myocardial infarction and stroke. Patients with type 2 diabetes mellitus are at higher risk for such conditions. The association of alcohol consumption with IMT is still controversial.

METHODS AND STUDY DESIGN

We undertook a cross-sectional study of patients hospitalized in the Department of Endocrinology at Zhoushan Hospital from January 1st, 2013 to December 31st, 2015. Patients with a past medical history of cerebrovascular events, acute myocardial ischemia or unable to provide a detailed alcohol consumption history were excluded. Carotid IMT, together with blood biochemical examinations were collected. Data were analyzed using least significant difference t test, Tamhane's T2 test, Levene test, χ2-test and binary logistic regression model.

RESULTS

281 patients were enrolled in the study. The number of patients with elevated carotid IMT in moderate alcohol consumers was apparently less than alcohol non/heavy-consumers. In addition, the number of participants with elevated carotid IMT in liqueur consumers was higher than alcohol non-consumers and rice wine/beer consumers. Systolic blood pressure, C-reactive protein, glycosylated hemoglobin, low density lipoprotein cholesterol, triglyceride, gamma glutamyl transpeptidase, uric acid, cholesterol and creatinine levels were higher in elevated IMT patients, while high density lipoprotein cholesterol level was levels were significantly lower (p value<0.05).

CONCLUSIONS

Moderate alcohol consumption has a protective effect on atherosclerosis in patients with type 2 diabetes mellitus, requiring consideration to dietary intake and physical activity, among other influences. Inflammation theory and lipid metabolism could be involved in such prophylaxis effects.

摘要

背景与目的

颈动脉内膜中层厚度(IMT)是心肌梗死和中风的风险预测因子。2 型糖尿病患者发生这些疾病的风险更高。饮酒与 IMT 的关系仍存在争议。

方法与研究设计

我们对 2013 年 1 月 1 日至 2015 年 12 月 31 日期间在舟山医院内分泌科住院的患者进行了一项横断面研究。排除有脑血管事件、急性心肌缺血病史或无法提供详细饮酒史的患者。收集颈动脉 IMT 及血液生化检查结果。采用最小显著差 t 检验、Tamhane's T2 检验、Levene 检验、χ2 检验和二项逻辑回归模型进行数据分析。

结果

共纳入 281 例患者。中度饮酒者的颈动脉 IMT 升高者明显少于非/重度饮酒者。此外,利口酒消费者的颈动脉 IMT 升高者比非饮酒者和米酒/啤酒消费者多。IMT 升高者的收缩压、C 反应蛋白、糖化血红蛋白、低密度脂蛋白胆固醇、甘油三酯、γ-谷氨酰转肽酶、尿酸、胆固醇和肌酐水平较高,而高密度脂蛋白胆固醇水平明显较低(p 值<0.05)。

结论

适度饮酒对 2 型糖尿病患者的动脉粥样硬化有保护作用,需要考虑饮食摄入和体力活动等因素。炎症理论和脂质代谢可能参与了这种预防作用。

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