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反应性低血糖患者的动脉粥样硬化危险因素

Atherosclerosis Risk Factors in Patients with Reactive Hypoglycemia.

作者信息

Landowska Małgorzata, Żebrowska Agata, Fajer Konrad, Adamek Patrycja, Kruk Aleksandra, Kałuża Bernadetta, Franek Edward

机构信息

Department of Internal Medicine, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, Warsaw, Poland.

Students Scientific Group of the Medical University of Warsaw at the Department of Internal Medicine, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, Warsaw, Poland.

出版信息

Diabetes Metab Syndr Obes. 2022 Oct 14;15:3133-3142. doi: 10.2147/DMSO.S371706. eCollection 2022.

Abstract

PURPOSE

Glucose metabolism disorders are an established risk factor for atherosclerosis. Although reactive hypoglycemia (RH) can be classified as one of these disorders, its role as a potential atherosclerosis risk factor remains unclear. The aim of the study was to assess whether patients with RH have a higher risk of atherosclerosis.

PATIENTS AND METHODS

We recruited 178 patients (N=178) with suspected RH who were hospitalized after 2014 and underwent a prolonged 5-hour oral glucose tolerance test. The study cohort was divided into 2 groups depending on the results of the oral glucose tolerance test: Group 1 - subjects without RH (n=44), Group 2 -subjects with RH (n=134).

RESULTS

The analyzed groups differed significantly in terms of the following risk factors for atherosclerosis: high-density lipoprotein (HDL) cholesterol levels (54.3±18.8 mg/dL vs 63±18.5 mg/dL, p=0.003) and atherogenic indices (Castelli I: 3.7±1.2 vs 3.1±1.3, p=0.004; Castelli II: 2.1±0.9 vs 1.7±0.9, p=0.007; the atherogenic index of plasma: 0.34±0.33 vs 0.18±0.3, p=0.006; and the atherogenic coefficient: 2.7±1.2 vs 2.1±1.3, p=0.004). Univariate logistic regression showed that RH should not be considered to be a predictor of an increased atherogenic index of plasma (odds ratio [OR]=0.3 [95% confidence interval [CI] [0.16-0.7], p=0.002). Multivariate logistic regression revealed triglyceride levels (OR 1.14 [1.07-1.2], p=0.001) and body weight (OR 1.07 [1.03-1.12], p=0.002) to be independent risk factors for atherosclerosis.

CONCLUSION

Atherosclerosis risk factors are no more prevalent in patients with RH. RH does not increase the risk of an abnormal atherogenic index of plasma.

摘要

目的

葡萄糖代谢紊乱是动脉粥样硬化公认的危险因素。尽管反应性低血糖(RH)可归类为这些紊乱之一,但其作为潜在动脉粥样硬化危险因素的作用仍不明确。本研究的目的是评估RH患者是否具有更高的动脉粥样硬化风险。

患者与方法

我们招募了178例2014年后住院且疑似患有RH的患者,并对其进行了长达5小时的口服葡萄糖耐量试验。根据口服葡萄糖耐量试验结果,将研究队列分为两组:第1组——无RH的受试者(n = 44),第2组——有RH的受试者(n = 134)。

结果

在以下动脉粥样硬化危险因素方面,分析的两组存在显著差异:高密度脂蛋白(HDL)胆固醇水平(54.3±18.8mg/dL对63±18.5mg/dL,p = 0.003)和致动脉粥样硬化指数(卡斯泰利I:3.7±1.2对3.1±1.3,p = 0.004;卡斯泰利II:2.1±0.9对1.7±0.9,p = 0.007;血浆致动脉粥样硬化指数:0.34±0.33对0.18±0.3,p = 0.006;以及致动脉粥样硬化系数:2.7±1.2对2.1±1.3,p = 0.004)。单因素逻辑回归显示,不应将RH视为血浆致动脉粥样硬化指数升高的预测因素(比值比[OR]=0.3[95%置信区间[CI][0.16 - 0.7],p = 0.002)。多因素逻辑回归显示甘油三酯水平(OR 1.14[1.07 - 1.2],p = 0.001)和体重(OR 1.07[1.03 - 1.12],p = 0.002)是动脉粥样硬化的独立危险因素。

结论

动脉粥样硬化危险因素在RH患者中并不更普遍。RH不会增加血浆异常致动脉粥样硬化指数的风险。

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