Logistic regression analysis of type 2 diabetes mellitus complicated with coronary heart disease risk factor
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摘要:
目的分析和评估2型糖尿病并发冠状动脉粥样硬化性心脏病（CHD）的主要危险因素。 方法选取2013~2014年明确诊断的2型糖尿病患者189例，测量和记录其并发CHD的相关因素并进行logistic回归分析。 结果在排除其他混杂因素后，2型糖尿病患者体质量指数、糖化血红蛋白和低密度脂蛋白胆固醇（LDL-C）升高并发CHD的优势比(OR)分别为：1.176（95%CI:1.029~1.343，P=0.017）、1.173（95%CI:1.010~1.363，P=0.036）和2.646（95%CI:1.513~4.627，P=0.001）；高密度脂蛋白胆固醇升高和高血压并发CHD的OR分别为：0.103（95%CI:0.017~0.628，P=0.014）和2.812（95%CI:1.637~4.803，P=0.006）。此外，其病程延长、体力活动增加发生CHD的OR分别为：1.449（95%CI:1.097~1.914，P=0.009）、0.438（95%CI: 0.245~0.784，P=0.005）。结论体质量指数、糖化血红蛋白、低密度脂蛋白胆固醇、血压升高和糖尿病病程延长为2型糖尿病并发CHD的主要危险因素，而HDL-C升高和体力活动增加为保护因素，应加强控制、管理和引导。 -
关键词:
- 2型糖尿病 /
- 冠状动脉硬化性心脏病 /
- 危险因素 /
- 糖化血红蛋白
Abstract:Objective To evaluate main risk factors of type 2 diabetes mellitus complicated with coronary heart disease. Methods A total of 189 patients with type 2 diabetes diagnosed from 2011 to 2012 were selected. The risk factors concurrent forCHD were measured and recorded to make a logistic regression analysis. Results With confounding factors ruled out, ORs forCHD in patients with type 2 diabetes were 1.176 (95% CI 1.029~1.343, P=0.017) with body mass index (BMI), 1.173 (95% CI1.010~1.363, P=0.036) with glycated haemoglobin (HbA1C) and 2.646 (95% CI 1.513~4.627, P=0.001) with low-densitylipoprotein cholesterol (LDL-C). Their ORs were 0.103 (95% CI 0.017~0.628, P=0.014) with high-density lipoprotein cholesterol(HDL-C) and 2.812（95% CI 1.637, 4.803, P=0.006）with hypertension. In addition, their ORs for CHD were 1.449 (95% CI 1.097~1.914, P=0.009) with duration of diabetes, 0.438 (95% CI 0.245~0.784, P=0.005) with increased physical activity. ConclusionBMI, HbA1C, LDL-c, high blood pressure and diabetic duration are the main risk factors of type 2 diabetes mellituscomplicated with CHD. Increased HDL-c and increased physical activity are protective factors, should be managed. -
Key words:
- Type 2 diabetes mellitus /
- coronary heart disease /
- risk factors /
- HbA1C
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表 1 两组患者一般资料分析结果〔x±s, n（%）〕
指标 对照组（n=99） CHD组（n=90） P值 年龄（岁） 58.8 ± 9.7 59.3±10.1 0.703 男性 52（52.53） 50（55.56） 0.676 2 型糖尿病病程（年） 3.5±1.4 4.3±1.4 0.000 吸烟 21（21.21） 30（33.33） 0.061 饮酒 15（15.15） 18（20.00） 0.380 高血压 28（28.28） 42（46.67） 0.001 家庭月收入人均3000 元以上 15（15.15） 18（20.00） 0.769 对婚姻状况满意 26（26.26） 17（18.89） 0.227 BMI(kg/m2) 24.55±3.14 26.73±3.18 0.000 FBG(mmol/L) 9.48±2.76 10.20±2.78 0.078 2 h-PG(mmol/L) 17.31±3.69 18.89±2.91 0.001 HbA1C (%) 8.18±2.23 9.73±2.97 0.000 FIB(g/L) 3.71±1.19 3.81±1.11 0.552 CRP(mmol/L) 8.61±5.79 9.21±5.41 0.464 TC(mmol/L) 4.71±1.29 5.01±1.21 0.102 TG(mmol/L) 1.93±1.13 2.13±1.26 0.251 LDL-C(mmol/L) 2.81±0.72 3.30±0.65 0.000 HDL-C(mmol/L) 1.18±0.20 1.02±0.26 0.000 
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表 2 两组患者文化程度、参加体育活动人数构成比（%）
分组 n 文化程度* 参加体育活动** 小学及以下 初中、高中 专科以上 很少参加 每周1 次以上 经常参加 对照组 99 39（39.39） 51（51.52） 9（9.09） 24（24.24） 45（45.46） 30（30.30） CHD组 90 45（50.00） 30（33.33） 15（16.67） 39（43.33） 39（43.33） 12（13.34） *P=0.031; **P=0.003.
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表 3 2型糖尿病患者并发心血管疾病多因素Logistic回归分析
指标 β SE χ2 P OR 95% CI 8 2 型糖尿病病程 0.371 0.142 6.815 0.009 1.449 (1.097，1.914) 8 BMI 0.162 0.068 5.675 0.017 1.176 (1.029，1.343) 8 LDL-C 0.973 0.285 11.633 0.001 2.646 (1.513，4.627) 8 HDL-C -2.271 0.922 6.073 0.014 0.103 (0.017，0.628) 8 2h-PG 0.128 0.072 3.211 0.073 1.137 (0.988，1.308) 8 HbA1C 0.160 0.076 4.385 0.036 1.173 (1.010，1.363) 8 高血压 1.012 0.293 8.356 0.006 2.812 (1.637，4.803) 8 文化程度 -0.097 0.305 0.101 0.751 0.908 (0.499，1.651) 8 体力活动 -0.826 0.297 7.716 0.005 0.438 (0.245，0.784) 8
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