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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 wordsDiabetes 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
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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.

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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

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