【摘要】 目的  探讨T2DM患者心血管病危险因素与不同血糖水平的相关性。 方法   选择健康对照(NC)者240名，T2DM组350例。收集两组病程、BMI、FPG及HbA1c等水平，并进行比较，分析HbA1c与心血管各项指标的相关性。 结果  T2DM组FPG、TG、TC、LDL-C、24 hPP、LVM和NT-proBNP较NC组升高， E/A、LVEF 、HDL-C较NC组降低（P<0.05）。7.0%≤HbA1c <8.0%亚组FPG、24 hPP、LVM、NT-proBNP、SBP、TC较6.0%≤HbA1c＜7.0%亚组升高，E/A、LVEF降低（P<0.05）。HbA1c≥8.0%亚组FPG、24 hPP、LVM、NT-proBNP、SBP、DBP、TC、TG、LDL-C较7.0%≤HbA1c <8.0%亚组升高，E/A、LVEF、HDL-C降低（P<0.05。相关分析显示，HbA1c与24 hPP、LVM及BNP呈正相关，与E/A及LVEF呈负相关。多元回归分析结果显示，HbA1c水平是老年T2DM患者的心血管危险因素。 结论  T2DM患者在血糖控制不佳时心血管系统损害尤为明显。T2DM和HbA1c控制差均是心血管疾病发生的独立危险因素。

     【关键词】 糖尿病，2型；糖化血红蛋白；心血管特点

Correlation between glucose level and cardiovascular risk factors in elderly patients with type 2 diabetes mellitus

     【Abstract】 Objective  To explore the correlation between glucose level and cardiovascular risk factors in elderly patients with type 2 diabetes mellitus. Methods  All the subjects were divided into two groups: normal control group (NC, n=240) and T2DM group (T2DM, n=350). Patients in T2DM group were further divided into three subgroups according to HbA1C level: 6.0%≤HbA1c＜7.0% subgroup, 7.0%≤HbA1c <8.0% subgroup and HbA1c≥8.0% subgroup. Duration of T2DM, BMI, FPG and HbA1c were collected and compared between two groups. The correlation between HbA1C level and various cardiovascular indicators was analyzed.  Results  FPG, TG, TC, LDL-C, 24 hPP, LVM and NT-proBNP were significantly higher while E/A, LVEF and HDL-C were significantly lower in T2DM group than in NC group (P<0.05).FPG, 24 hPP, LVM, NT-proBNP, SBP and TC were significantly higher while E/A and LVEF were significantly lower in 7.0%≤HbA1c <8.0% subgroup than in 6.0%≤HbA1c＜7.0% subgroup(P<0.05). FPG, 24 hPP, LVM, NT-proBNP, SBP, DBP, TC, TG and LDL-C were significantly higher while E/A, LVEF and HDL-C were significantly lower in HbA1c≥8.0% subgroup than in 7.0%≤HbA1c <8.0% subgroup (P<0.05). Correlation analysis showed that HbA1clevel was positively correlated with 24 hPP, LVM and BNP and negatively correlated with E/A and LVEF. Multiple regression analysis showed that HbA1c level was a cardiovascular risk factor for elderly patients with T2DM. Conclusion  Damage to cardiovascular system in elderly patients with T2DM is particularly obvious when the patients were at poor glycemic control. T2DM and poor control of HbA1clevel are independent risk factors for cardiovascular disease.

    【Key words】 Diabetes mellitus, type 2; Glycated hemoglobin (HbA1c); Cardiovascular characteristics