·糖尿病临床研究·

魏丽 章建梅 刘朝晖 祝超瑜 张锋 贾伟平

基金项目:国家自然科学基金资助项目(30670989) ;上海市糖尿病重点实验室项目(08DZ2230200)

作者单位:200233上海市糖尿病临床医学中心、上海糖尿病重点实验室、上海市糖尿病研究所、上海市第六人民医院内分泌代谢科(魏丽、章建梅、 祝超瑜、张锋、贾伟平);云南省红河州第一人民医院内分泌科(刘朝晖)

【摘要】 目的 探讨2型糖尿病(T2DM)患者非增生型视网膜病变(NPDR)与颈动脉内膜中层厚度(IMT)之间的关系。 方法 选择NPDR组97例，糖尿病正常眼底(NDR)对组照100例。B超检测IMT。 结果 (1)NPDR组IMT明显高于NDR组(P<0.01)。(2)NPDR与年龄、病程、收缩压、舒张压、糖化血红蛋白、IMT、尿白蛋白呈正相关(P<0.05)，与HDL-C、餐后2h C肽呈负相关(P<0.05)。Logistic回归显示IMT是NPDR的主要危险因素(P<0.01)。(3)IMT增厚组(60.7%) NPDR发病率明显高于正常组(44.1%)(P<0.05)。 结论 T2DM合并颈动脉IMT增厚者NPDR发病率显著增高，推测动脉粥样硬化可能是NPDR的一个重要的相关因素。

【关键词】 糖尿病，2型;糖尿病非增生型视网膜病变;颈动脉内膜中层厚度

doi:10.3969/j.issn.1006-6187.2011.07.012

Relationship between non-proliferative diabetic retinopathy and the carotid artery intima-media thickness in type 2 diabetic patients

WEI Li, ZHANG Jian-mei, LIU Zhao-hui,et al. Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus,Shanghai Institute of Diabetes, Department of Endocrinology and Metabolism,Shanghai No.6 People′s Hospital Affiliated to Jiaotong University, Shanghai 200233,China

【Abstract】 Objective To explore the relationship between non-proliferative diabetic retinopathy and the carotid artery intima-media thickness(IMT) in type 2 diabetic patients. Method s197 patients with type 2 diabetes mellitus were divided into two groups,97 patients with non-proliferative diabetic retinopathy (NPDR) and 100 patients without diabetic retinopthy (NDR). Intima-media thickness was measured using B mode ultrasonography. Result s(1)IMT was significantly higher in patients with NPDR than in patients without DR( P<0.01);(2)NPDR was positively correlated with age, the course of disease, systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin, IMT, urinary microalbumin (P<0.05) and was negatively correlated with high density lipoprotein-cholesterol, 2h C-Peptide(P<0.05). Logistic regression analysis showed that IMT was the most important risk factor for NPDR (P<0.01);(3)In diabetic patients，the prevalence of diabetic retinopathy was higher in thickened IMT group(60.7%) than in normal IMT group(44.1%)(P<0.05). Conclusion sThe morbidity of NPDR is higher in type 2 diabetic patients complicated with thickened IMT, speculating that atherosclerosis may be a critical relative factor of NPDR.

【Key words】 Diabetes mellitus, type 2;Non-proliferative diabetic retinopathy;Intima-medial thickness,Carotid artery