目的 探讨非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值（non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio,NHHR）对2型糖尿病（diabetes mellitus type 2,T2DM）患者颈动脉内膜-中膜厚度（carotid intima-media thickness,CIMT）增加的预测效能。方法 选取2022年7月至2024年5月我院360例T2DM患者作为研究对象,根据患者是否发生CIMT增厚,分为单纯T2DM组（n=208）、CIMT增厚组（n=152）。比较两组一般资料、NHHR,分析各指标与CIMT增厚的相关性,分析T2DM患者CIMT增厚的影响因素,分析NHHR对T2DM患者CIMT增厚的预测价值。结果 CIMT增厚组总胆固醇（total cholesterol,TC）、T2DM病程、非高密度脂蛋白胆固醇（non-high-density lipoprotein cholesterol,non-HDL-C）、糖化血红蛋白（hemoglobin A1c,HbA1c）、高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、NHHR高于单纯T2DM组,低密度脂蛋白胆固醇（low-density lipoprotein cholesterol,LDL-C）低于单纯T2DM组;T2DM病程、non-HDL-C、HbA1c、NHHR、TC、HDL-C与CIMT增厚呈正相关,LDL-C与CIMT增厚呈负相关;调整T2DM病程、non-HDL-C、HbA1c因素前后,NHHR仍是T2DM患者CIMT增厚的影响因素;non-HDL-C、HDL-C、NHHR单独预测患者CIMT增厚的曲线下面积分别为0.705、0.846、0.895。 NHHR预测效能明显高于HDL-C。结论 T2DM患者NHHR升高与CIMT增厚有关,与单独non-HDL-C、HDL-C比较,NHHR在预测患者CIMT增厚方面预测效能较高。
Abstract
Objective To investigate the predictive efficacy of the non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (NHHR) on the thickening of carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 360 patients with T2DM in our hospital from July 2022 to May 2024 were selected as the research subjects. According to whether they developed thickening of CIMT, they were divided into the simple T2DM group (n=208) and the CIMT thickening group (n=152). Compare the general data and NHHR of the two groups, analyze the correlations between each indicator and the thickening of CIMT, analyze the influencing factors of CIMT thickening in patients with T2DM, and analyze the predictive value of NHHR for CIMT thickening in patients with T2DM. Results The CIMT thickening group had higher levels of total cholesterol (TC), duration of T2DM, non-high-density lipoprotein cholesterol (non-HDL-C), hemoglobin A1c (HbA1c), high-density lipoprotein cholesterol (HDL-C), and NHHR compared to the simple T2DM group, the low-density lipoprotein cholesterol (LDL-C) was lower in the CIMT thickening group than in the simple T2DM group. The course of T2DM, non-HDL-C, HbA1c, NHHR, TC, HDL-C are positively correlated with CIMT thickening, while LDL-C is negatively correlated with CIMT thickening; after adjusting for T2DM duration, non-HDL-C, and HbA1c, NHHR remained an influencing factor for the thickening of CIMT in T2DM patients; the areas under the curve for non-HDL-C, HDL-C, and NHHR in predicting the thickening of CIMT in patients were 0.705, 0.846, and 0.895 respectively, and the predictive efficacy of NHHR was significantly higher than that of HDL-C. Conclusion The increase in NHHR in patients with T2DM is associated with the thickening of CIMT. Compared with non-HDL-C and HDL-C alone, NHHR has a higher predictive efficacy in predicting the thickening of CIMT in patients.
关键词
非高密度脂蛋白胆固醇 /
2型糖尿病 /
高密度脂蛋白胆固醇 /
颈动脉内膜中膜厚度 /
增厚 /
预测
Key words
non-high-density lipoprotein cholesterol /
type 2 diabetes /
high-density lipoprotein cholesterol /
carotid intima-media thickness /
thickening /
prediction
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基金
茂名市科技计划项目“NHHR对2型糖尿病患者颈动脉内膜中层增厚的预测价值”（2025131）; 广东省中医药局科研项目 “经皮穴位电刺激术联合君子消痞汤改善糖尿胃轻瘫病的作用及机制研究”（20211451）
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