Relationship between epicardial adipose tissue thickness and carotid intima-media thickness in overweight and obese patients with type 2 diabetes
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摘要 目的:探讨超重及肥胖2型糖尿病(T2DM)患者心外膜脂肪组织(EAT)厚度与颈动脉内膜中层厚度(CIMT)的关系。方法:选取合肥市第一人民医院滨湖院区内分泌科住院T2DM患者131例,根据体质量指数分为正常体重组(体质量指数18.5~23.9 kg/m2,n=44)与超重及肥胖组(体质量指数≥24.0 kg/m2,n=87)。收集患者的一般临床资料及生化检验指标,同时完善颈动脉超声检查记录CIMT,心脏超声检查记录EAT厚度。计量资料两组间比较采用独立样本t检验、Mann-Whitney U检验。计数资料两组间比较采用χ2检验。对超重及肥胖组T2DM患者进行Spearman相关分析CIMT与EAT厚度之间的关系,多元逐步线性回归分析CIMT的独立危险因素。结果:与正常体重组相比,超重及肥胖的T2DM患者,其空腹血糖(FPG)、空腹C肽(FC-P)、甘油三酯(TG)、血清尿酸(SUA)、单核细胞(MO)、EAT厚度、CIMT均升高,差异有统计学意义(P＜0.05)。在超重及肥胖的T2DM患者中,CIMT与体质量指数、TG、MO、EAT厚度呈正相关关系(r=0.683、0.236、0.621、0.936,P＜0.01),EAT厚度与体质量指数、TG、MO、CIMT呈正相关关系(r=0.648、0.234、0.603、0.936,P＜0.01),EAT厚度及体质量指数是CIMT增厚的危险因素。结论:超重及肥胖的T2DM患者EAT厚度增厚,且与CIMT密切相关,是CIMT增厚的危险因素。Abstract Objective: To investigate the relationship between epicardial adipose tissue (EAT) thickness and carotid intima-media thickness (CIMT) in overweight and obese patients with type 2 diabetes (T2DM).Methods: A total of 131 T2DM patients from the Department of Endocrinology in Binhu District of Hefei First People’s Hospital were selected and divided into normal weight group (BMI 18.5-23.9 kg/m2,n=44) and overweight and obese group (BMI≥24.0 kg/m2,n=87) according to BMI.The general clinical data and biochemical test indexes of patients were collected,and the carotid artery ultrasound was improved to record CIMT and the cardiac ultrasound to record EAT thickness.The measurement data between the two groups were compared by independent sample t test and Mann-Whitney U test.Statistical data were compared between the two groups using χ2test.Spearman correlation analysis was performed for the relationship between CIMT and EAT thickness in the T2DM patients in the overweight and obese group,and multiple stepwise linear regression analysis was performed for the independent risk factors of CIMT.Results: Compared with the normal weight group,fasting plasma glucose (FPG),fasting c-peptide (FC-P),triglyceride (TG),serum uric acid (SUA),monocyte (MO),EAT thickness and CIMT in overweight and obese patients with T2DM were all increased,and the difference was statistically significant (P＜0.05).In overweight and obese T2DM patients,CIMT was positively correlated with BMI,TG,SUA,MO and EAT thickness (r=0.683,0.236,0.621,0.936,P＜0.01),EAT thickness was positively correlated with BMI,TG,MO and CIMT (r=0.648,0.234,0.603,0.936,P＜0.01),and EAT thickness and BMI were risk factors for CIMT.Conclusion: The increase of EAT thickness in overweight and obese T2DM patients is closely related to CIMT,which is a risk factor for CIMT.
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