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胆囊容积:糖尿病患者与对照组的比较

Gallbladder volume: comparison of diabetics and controls.

作者信息

Chapman B A, Chapman T M, Frampton C M, Chisholm R J, Allan R B, Wilson I R, Burt M J

机构信息

Department of Gastroenterology, Christchurch Hospital, Christchurch School of Medicine, New Zealand.

出版信息

Dig Dis Sci. 1998 Feb;43(2):344-8. doi: 10.1023/a:1018810523399.

Abstract

Diabetics are known to have an increased prevalence of gallstones. The aim of this study was to investigate whether diabetics have increased gallbladder volumes that would predispose to stasis, nucleation of cholesterol crystals, and gallstone formation. The gallbladder volume of 271 diabetic subjects and 277 controls was determined by ultrasound using the ellipse formula. Gallbladder volume was also determined by the sum of the cylinders method in 143 cases with a strong correlation (r = 0.89) between the two methods. Using analysis of variance, gallbladder volume was influenced by both diabetic type (NIDDM = 33.68 cm3, IDDM = 26.84 cm3, controls = 29.05 cm3; P = 0.018) and the presence of gallstones (gallstones = 32.04 cm3, no gallstones = 27.58 cm3; P = 0.018). The variation in gallbladder volume between NIDDM, IDDM, and control subjects was influenced by the presence of gallstones (P = 0.024, interaction term from ANOVA). Significant differences (P < 0.001) were only found between NIDDM vs IDDM and NIDDM vs control in the nongallstone group (NIDDM = 34.33 cm3, IDDM = 25.08 cm3, control = 25.17 cm3). Males had significantly larger gallbladder volumes than females: 31.98 cm3 vs 27.74 cm3 (P = 0.023). After the inclusion of BMI, HDL cholesterol, triglyceride, and age in a statistical model with gender and diabetic type in those without gallstones, significant differences were still found between NIDDM and IDDM (P = 0.013) and NIDDM and controls (P = 0.005), demonstrating that NIDDM is an independent predictor for increased gallbladder volume.

摘要

众所周知,糖尿病患者胆结石的患病率会升高。本研究的目的是调查糖尿病患者的胆囊容积是否增加,而这会导致胆汁淤积、胆固醇结晶成核以及胆结石形成。采用椭圆公式通过超声测定了271名糖尿病患者和277名对照者的胆囊容积。还采用圆柱体法对143例患者测定了胆囊容积,两种方法之间具有很强的相关性(r = 0.89)。使用方差分析,胆囊容积受糖尿病类型(非胰岛素依赖型糖尿病 = 33.68立方厘米,胰岛素依赖型糖尿病 = 26.84立方厘米,对照者 = 29.05立方厘米;P = 0.018)和胆结石的存在情况(有胆结石 = 32.04立方厘米,无胆结石 = 27.58立方厘米;P = 0.018)的影响。非胰岛素依赖型糖尿病、胰岛素依赖型糖尿病和对照者之间胆囊容积的差异受胆结石存在情况的影响(P = 0.024,方差分析的交互项)。仅在无胆结石组中,非胰岛素依赖型糖尿病与胰岛素依赖型糖尿病以及非胰岛素依赖型糖尿病与对照者之间发现了显著差异(P < 0.001)(非胰岛素依赖型糖尿病 = 34.33立方厘米,胰岛素依赖型糖尿病 = 25.08立方厘米,对照者 = 25.17立方厘米)。男性的胆囊容积显著大于女性:31.98立方厘米对27.74立方厘米(P = 0.023)。在无胆结石的人群中,将体重指数、高密度脂蛋白胆固醇、甘油三酯和年龄纳入包含性别和糖尿病类型的统计模型后,非胰岛素依赖型糖尿病与胰岛素依赖型糖尿病之间(P = 0.013)以及非胰岛素依赖型糖尿病与对照者之间(P = 0.005)仍存在显著差异,表明非胰岛素依赖型糖尿病是胆囊容积增加的独立预测因素。

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