·糖尿病临床流行病学·

　　基金项目：国家自然科学基金资助项目(30700381);上海市科委引领计划项目(74119638)

　　作者单位：200080上海交通大学附属第一人民医院内分泌代谢科

　　通讯作者：彭永德，E-mail: pyongde@hotmail.com

　　吴景程 李晓华 彭永德 董维平

　　【摘要】 目的 探讨2型糖尿病(T2DM)患者代谢综合征(MS)组分与糖尿病血管并发症的关联。 方法 412例 T2DM住院患者，按是否合并MS分为MS组和T2DM组，比较两组间糖尿病血管并发症相关指标的差异及其与MS组分的关联。 结果 MS组心血管疾病(CVD)和糖尿病肾病(DN)的发病率明显高于T2DM组。多元逐步回归显示，HDL-C是颈动脉内中膜厚度的独立影响因素;平均动脉压、HDL-C和MS组分数是尿白蛋白排泄率的独立影响因素。 结论 T2DM患者MS及其组分与CVD和DN相关。

　　【关键词】糖尿病，2型;代谢综合征;并发症;尿白蛋白排泄率;颈动脉内中膜厚度

　　doi:10.3969/j.issn.1006-6187.2011.08.003

　　Relationship of the metabolic syndrome (MS) and its components with diabetic vascular complications in type 2 diabetic patients

　　WU Jing-cheng, LI Xiao-hua, PENG Yong-de, et al. Department of Endocrinology and Metabolism, Shanghai Jiao Tong University affiliated First People′s Hospital, Shanghai 200080, China

　　Corresponding author: PENG Yong-de, E-mail: pyongde@hotmail.com

　　【Abstract】 ObjectiveTo investigate the relationship of metabolic syndrome(MS) and its components with diabetic vascular complications in type 2 diabetic patients. Methods The 412 type 2 diabetic patients were divided into two groups with (n=213) and without (n=199)MS. The prevalence of diabetic vascular complications was compared between two groups. The correlations of the components of the metabolic syndrome with the level of urinary albumin excretion rate (UAER) and carotid artery intima-media thickness (IMT) were analyzed. Results (1) The prevalence of cardiovascular disease(8.1% vs 25.4%，P<0.01) and diabetic nephropathy (44.2% vs 63.8%，P<0.01) was significantly higher in patients with MS than those without MS. (2) Multiple regression analysis demonstrated that HDL-C was an independent determinant of IMT(β=-0.01，P<0.05); and MAP, HDL-C and the number of MS components were independent determinants of UAER(β=0.12, P<0.05; β=-0.16, P<0.01; β=0.15, P<0.05). ConclusionMS and its components are associated with cardiovascular disease and diabetic nephropathy in type 2 diabetic patients.

　　【Key words】Diabetes, type 2; Metabolic syndrome; Complications; Urinary albumin excretion rate; Carotid artery intima-media thickness