Please wait a minute...
浙江大学学报（医学版）
浙江大学学报（医学版）  2016, Vol. 45 Issue (3): 268-274    DOI: 10.3785/j.issn.1008-9292.2016.05.08
原著     
2型糖尿病患者合并代谢综合征增加Framingham心血管危险评分
姚美芳1,2, 孙雪1, 韩珏1, 屠伊娜1, 何洁1, 赵一鸣1, 楼寒钰1, 庞晓红1, 曾文衡1, 张松照3, 单鹏飞1
1. 浙江大学医学院附属第二医院内分泌科, 浙江 杭州 310009;
2. 浙江医院健康管理中心, 浙江 杭州 310013;
3. 浙江大学医学院附属第二医院检验科, 浙江 杭州 310009
Metabolic syndrome increases Framingham risk score of patients with type 2 diabetes mellitus
YAO Meifang1,2, SUN Xue1, HAN Jue1, TU Yina1, HE Jie1, ZHAO Yiming1, LOU Hanyu1, PANG Xiaohong1, ZENG Wenheng1, ZHANG Songzhao3, SHAN Pengfei1
1. Department of Endocrinology and Metabolism, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China;
2. Health Management Center, Zhejiang Hospital, Hangzhou 310013, China;
3. Department of Clinical Laboratory, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
全文: PDF(1001 KB)  
摘要: 

目的：采用Framingham心血管危险评分（FRS）探讨2型糖尿病患者合并代谢综合征对10年心血管疾病风险的影响。方法：入选1708例于2008年5月至2013年4月在浙江大学医学院附属第二医院住院治疗的2型糖尿病患者，测定人体形态学和生化指标。采用ATPⅢ 2005亚洲标准诊断代谢综合征，按不同性别分为未合并代谢综合征组和合并代谢综合征组。结果：男女性2型糖尿病合并代谢综合征组腰围、体质量、体质指数、收缩压、舒张压、空腹c肽、总胆固醇、甘油三酯和低密度脂蛋白胆固醇均高于未合并代谢综合征组（均P<0.05），高密度脂蛋白胆固醇低于未合并代谢综合征组（P<0.01）。合并代谢综合征组FRS男性[13.0（10.0，15.0）与11.0（9.0，13.0）]、女性[15.0（12.0，18.0）与12.0（6.0，14.8）]和10年心血管风险男性[12.0%（6.0%，20.0%）与8%（5.0%，12.0%）]、女性[3.0%（1.0%，6.0%）与1.0%（0.0%，2.8%）]均高于未合并代谢综合征组（均P<0.01）。FRS和10年心血管风险随代谢综合征组分增加而增加。结论：2型糖尿病患者合并代谢综合征心血管危险因素增加，进一步增加FRS和10年心血管疾病风险。
关键词 ： 糖尿病,2型/流行病学,  代谢综合征X/并发症,  心血管疾病/预防和控制,  危险因素    
Abstract：

Objective: To assess the impact of metabolic syndrome(MS) on Framingham risk score(FRS) in patients with type 2 diabetes mellitus (T2DM). Methods: The anthropometric and biochemical data of 1708 patients with T2DM admitted in hospital from May 2008 to April 2013 were retrospectively analyzed, including 902 males and 806 females with a mean age of 57.1±11.8 years (20-79 years). Diagnosis of MS was made according to the criteria of the Adult Treatment Panel Ⅲ Criteria modified for Asians. Results: Compared to non-MS/T2DM patients, MS/T2DM patients had higher waist circumference, body weight, body mass index, systolic and diastolic blood pressure, fasting C peptide, total cholesterol, triglyceride, and LDL-C (P<0.05), while lower HDL-C (P<0.01). Both FRS [13.0(10.0, 15.0) vs 11.0(9.0, 13.0) in male,15.0(12.0, 18.0) vs 12.0(6.0, 14.8) in female,P<0.01)] and 10-year cardiovascular risk [12.0%(6.0%, 20.0%) vs 8.0%(5.0%,12.0%) in male,3.0%(1.0%, 6.0%) vs 1.0%(0.0%, 2.8%) in female,P<0.01] were higher in MS/T2DM patients than those in non-MS/T2DM patients.Both FRS and 10-year cardiovascular risk were increased with the components of MS. Conclusion: T2DM patients with MS have more cardiovascular risk factors, higher FRS and 10-year cardiovascular risk.
Key words： Diabetes mellitus, type 2/epidemiology    Metabolic syndrome X/complications    Cardiovascular diseases/prevention &    control    Risk factors
收稿日期: 2015-12-03
CLC:  R743  
基金资助:

国家自然科学基金（81370968）；中华医学会临床医学科研专项基金（13040620447）；浙江省教育厅科研项目（Y201328533）
通讯作者: 单鹏飞(1977-),男,博士,副主任医师,从事内分泌代谢疾病的研究;E-mail:shanpf95@hotmail.com;http://orcid.org/0000-0002-6684-9395     E-mail: shanpf95@hotmail.com
作者简介: 姚美芳(1979-),女,硕士研究生,主治医师,从事健康管理工作;E-mail:yaomf1979@126.com;http://orcid.org/0000-0003-2761-710X
服务　　
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章　　

引用本文:

姚美芳 等. 2型糖尿病患者合并代谢综合征增加Framingham心血管危险评分[J]. 浙江大学学报（医学版）, 2016, 45(3): 268-274.
YAO Meifang, SUN Xue, HAN Jue, TU Yina, HE Jie, ZHAO Yiming, LOU Hanyu, PANG Xiaohong, ZENG Wenheng, ZHANG Songzhao, SHAN Pengfei. Metabolic syndrome increases Framingham risk score of patients with type 2 diabetes mellitus. Journal of ZheJiang University(Medical Science), 2016, 45(3): 268-274.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2016.05.08      或      http://www.zjujournals.com/xueshu/med/CN/Y2016/V45/I3/268

[1] KISHORE P, KIM S H, CRANDALL J P. Glycemic control and cardiovascular disease: what's a doctor to do?[J]. Curr Diab Rep, 2012, 12(3):255-264.
[2] 李光伟. 关注血糖达标与低血糖风险之间的平衡——谈糖尿病合并心血管疾病的降血糖治疗[J].中华内分泌代谢杂志, 2012,28(1):1-3. LI Guangwei. Pay more attention to the balance between "treat to target" and risk of hypoglycemia comment on the strategy of glycemic control in diabetic patients with cardiovascular disease[J]. Chinese Journal of Endocrinology and Metabolism, 2012, 28(1):1-3. (in Chinese)
[3] YIN J H, SONG Z Y, SHAN P F, et al. Age-and gender-specific prevalence of carotid atherosclerosis and its association with metabolic syndrome in Hangzhou, China[J]. Clin Endocrinol (Oxf), 2012, 76(6): 802-809.
[4] BODEN-ALBALA B,SACCO R L,LEE H S,et al. Metabolic syndrome and ischemic stroke risk Northern Manhattan Study[J]. Stroke, 2008,39(1): 30-35.
[5] RHEE S Y, PARK S Y, HWANG J K, et al. Metabolic syndrome as an indicator of high cardiovascular risk in patients with diabetes: analyses based on Korea National Health and Nutrition Examination Survey (KNHANES) 2008[J]. Diabetol Metab Syndr, 2014, 6(1):98.
[6] BAE J C, CHO N H, SUH S, et al. Cardiovascular disease incidence, mortality and case fatality related to diabetes and metabolic syndrome: a community-based prospective study(Ansung-Ansan cohort 2001-12)[J]. Diabetes, 2014, 7(6):791-799.
[7] MEHTA N N, KRISHNAMOORTHY P, MARTIN S S, et al. Usefulness of insulin resistance estimation and the metabolic syndrome in predicting coronary atherosclerosis in type 2 diabetes mellitus[J]. Am J Cardiol, 2011, 107(3): 406-411.
[8] SCOTT R, DONOGHOE M, WATTS G F, et al. Impact of metabolic syndrome and its components on cardiovascular disease event rates in 4900 patients with type 2 diabetes assigned to placebo in the FIELD randomised trial[J]. Cardiovasc Diabetol, 2011, 10:102.
[9] Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report[J]. Circulation, 2002, 106(25):3143-3421.
[10] GRUNDY S M, CLEEMAN J I, DANIELS S R, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement[J]. Circulation, 2005, 112(17): 2735-2752.
[11] WHITING D R, GUARIGUATA L, WEIL C, et al. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030[J]. Diabetes Res Clin Pract, 2011, 94(3): 311-321.
[12] GUARIGUATA L, WHITING D R, HAMBLETON I, et al. Global estimates of diabetes prevalence for 2013 and projections for 2035[J]. Diabetes Res Clin Pract, 2014, 103(2):137-149.
[13] XU Y,WANG L,HE J,et al. Prevalence and control of diabetes in Chinese adults[J]. JAMA,2013, 310(9): 948-959.
[14] Action to Control Cardiovascular Risk in Diabetes Study Group, GERSTEIN H C, MILLER M E, et al. Effects of intensive glucose lowering in type 2 diabetes[J]. N Engl J Med, 2008, 358(24): 2545-2559.
[15] KIM C J, KANG H S, SCHLENK E A, et al. Assessment of cardiovascular risk in adults with type 2 diabetes and metabolic syndrome: Framingham versus UKPDS equations[J]. Diabetes Educ, 2015, 41(2): 203-213.
[16] SALEEM T, MOHAMMAD K H, ABDEL-FATTAH M M, et al.Association of glycosylated haemoglobin level and diabetes mellitus duration with the severity of coronary artery disease[J]. Diab Vasc Dis Res, 2008, 5(3):184-189.
[17] GAO Y, LU B, SUN M L, et al.Comparison of atherosclerotic plaque by computed tomography angiography in patients with and without diabetes mellitus and with known or suspected coronary artery disease.[J]. Am J Cardiol, 2011,108(6): 809-813.
[18] FRANZINI L, ARDIGÒ D, CAVALOT F et al. Women show worse control of type 2 diabetes and cardiovascular disease risk factors than men: results from the MIND.IT Study Group of the Italian Society of Diabetology[J]. Nutr Metab Cardiovasc Dis, 2013, 23(3):235-241.
[1] 王科等. 进展性脑挫裂伤危险因素及与预后关系的分析[J]. 浙江大学学报（医学版）, 2015, 44(4): 410-416.
[2] 程龙宇, 等. 成人肝移植后发生持续性血小板减少的危险因素分析及其预防措施探讨[J]. 浙江大学学报（医学版）, 2014, 43(6): 670-677.
[3] 吴健，等. 原发性肝癌自发性破裂的预测模型构建[J]. 浙江大学学报（医学版）, 2014, 43(6): 652-657.
[4] 余馨妍，赵奕，宋筱筱，等. 人体质量指数与非酒精性脂肪性肝病发生和消退的关系[J]. 浙江大学学报（医学版）, 2014, 43(5): 546-.
[5] . 浙江地区女性乳腺癌危险因素的病例对照研究[J]. 浙江大学学报（医学版）, 2012, 41(5): 512-518.
[6] . 谷氨酰转肽酶与老年高血压和高血压伴糖尿病患者心血管危险因素的关系探讨[J]. 浙江大学学报（医学版）, 2012, 41(2): 192-195.
[7] 何小军，谈林华，朱力行，范佳杰. 法洛四联症术后毛细血管渗漏综合征的危险因素及治疗[J]. 浙江大学学报（医学版）, 2008, 37(4): 413-417.
[8] 胡申江. 重视动脉粥样硬化"非传统"危险因素的研究[J]. 浙江大学学报（医学版）, 2002, 31(5): 313-315.
[9] 陈坤;裘炯良;张扬. 大肠癌危险因素的Meta分析[J]. 浙江大学学报（医学版）, 2002, 31(4): 254-258.
[10] 周雪娟;赵正言;水泉祥;陈坤;郑凯航. 小儿脑瘫危险因素的1:2配比病例对照研究[J]. 浙江大学学报（医学版）, 2002, 31(2): 107-110.
[11] 周伦, 余海, 郑树. 杭州市大肠癌危险因素分析[J]. 浙江大学学报（医学版）, 1996, 25(5): 204-206.