| 摘要: |
| 目的探讨住院2型糖尿病患者BMI与代谢指标及慢性并发症的关系。方法将508例2型糖尿病患者根据BMI不同分为肥胖组（BMI≥25kg/m2）206例及非肥胖组（BMI＜25kg/m2）302例。测量并比较两组患者的身高、腰围、臀围、体重、血压（收缩压、舒张压），并计算BMI、腰围身高比值、腰臀比以及相关实验室检查[TC、TG、LDL-C、HDL-C、空腹血糖（FBG）、餐后2h血糖、糖化血红蛋白（HbA1c）、空腹胰岛素（FIN）、血尿酸（SUA）、肝酶（ALT、AST、ALP、GGT）]，同时比较两组患者慢性并发症发生情况。采用Pearson相关分析BMI与上述各指标的关系，采用逐步多元回归法分析BMI的最相关影响因素。结果肥胖组BMI、腰围身高比值、腰臀比、收缩压、舒张压均高于非肥胖组，两组比较差异均有统计学意义（均P＜0.05）。同时，肥胖组患者FBG、HbA1c、TG、ALT、AST、GGT、SUA、FIN、IRI亦高于非肥胖组，差异均有统计学意义（均P＜0.05）。Pearson相关进行分析显示，BMI与腰围身高比值、腰臀比、收缩压、舒张压、FBG、HbA1c、TG、ALT、AST、GGT、SUA、FIN及IRI呈正相关。逐步多元回归法分析显示，IRI、SUA、舒张压、ALT为最相关影响因素。肥胖组冠心病、糖尿病肾脏病变、高血压发病率及脂肪肝患病率与非肥胖组比较，差异均有统计学意义（均P＜0.05）。结论BMI越高的2型糖尿病患者的胰岛素抵抗越明显，其FBG、TG、SUA水平越高，更易出现高血压、脂肪肝、冠心病、肾脏病变。2型糖尿病患者积极控制体重，积极纠正血糖、血脂、SUA水平，有利于降低罹患高血压、脂肪肝、冠心病、糖尿病肾脏病变风险。 |
| 关键词: 2 型糖尿病 体重指数 肥胖 高血压 |
| DOI： |
| 分类号: |
| 基金项目:丽水市科技计划项目 |
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| Associations of body mass index with metabolic status and chronic complications in type 2 diabetic patients |
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GUAN Changrong,ZHU Yingbiao,JI Meixia,CHEN Riqiu
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Lishui People's Hospital
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| Abstract: |
| Objective To investigate the association of body mass index (BMI) with metabolic status and chronic complications in type 2 diabetic patients. Methods Total 508 patients with type 2 diabetes were enrolled in the study, including 206 cases with overweight/obesity(BMI≥25kg/m2) and 302 cases without overweight/obesity(BMI＜25kg/m2). The height, weight, blood pressure, FBG, PBG2h, BMI, TG, TC, LDL-C, HDL-C, SBP, DBP, HbA1c, serum uric acid, fasting insulin, liver enzymes (ALT, AST, ALP, GGT), urinary albumin were measured. The BMI, WHtR and WHR were calculated. Metabolic indicators and the incidence of the chronic complication were observed. Results There were significant differences in BMI, WHtR, WHR, SBP, DBP, FBG, HbA1c, TG, ALT, AST, GGT, serum uric acid, fasting insulin and insulin sensitivity index between two groups(P＜0.05);
while there were no significant differences in sex, course of disease, smoking, alcohol drinking, family history, PBG2h, TC, LDL-C, HDL-C and ALP between two groups(P ＞0.05). Pearson correlation analysis showed that BMI was positively correlated with WHtR, WHR, SBP, DBP, FBG, HbA1c, TG, ALT, AST, GGT, serum uric acid, fasting insulin and insulin sensitivity index. Stepwise multiple regression analysis showed that BMI was most relevant factor for insulin sensitivity index, serum uric acid, DBP and ALT. Compared with non-overweight/obesity group, the prevalence rates of coronary heart disease, diabetes nephropathy, hypertension and fatty liver were significantly increased in overweight/obesity group. Conclusion Overweight and obesity are closely related to insulin resistance, blood sugar, triglycerides and uric acid levels, prevalence of high blood pressure, fatty liver, coronary heart disease and diabetic nephropathy in diabetic patients. |
| Key words: T2DM BMI Obesity Hypertension |
