超声评价2 型糖尿病患者心外膜脂肪厚度 与内皮功能的相关性

Evaluation of epicardial adipose tissue thickness of the patients with type 2 diabetes mellitus by ultrasonography and its correlation with endothelial function

摘要:

目的 应用超声技术评价2 型糖尿病（T2DM）患者心外膜脂肪厚度及与内皮功能的相关性。 方法 选取2017 年12 月—2018 年9 月大连医科大学附属第二医院收治的T2DM 患者120 例。根据患者 T2DM 病程长短，将患者分为病程≤ 10 年组和病程>10 年组，均为60 例。另收集60 例健康志愿者作为对照组。 应用超声技术分别测量心外膜脂肪组织厚度和右侧肱动脉血流介导的内皮依赖性血管舒张功能，并获得相关的 临床和实验室指标。结果 病程>10 年组糖尿病病程、糖化血红蛋白（HbA1c）、甘油三酯（TG）及低密度脂 蛋白（LDL）均高于病程≤ 10 年组（P <0.05）。病程≤ 10 年组、病程>10 年组心外膜脂肪组织厚度均较对照 组高（P <0.05），病程≤ 10 年组、病程>10 年组血管舒张功能均较对照组低（P <0.05）。血管舒张功能与年龄、 糖尿病病程、HbA1c、总胆固醇、TG、LDL、心外膜脂肪组织厚度、C 肽及空腹血糖均呈负相关（r =-0.333、 -0.743、-0.705、-0.443、-0.819、-0.556、-0.761、-0.400 和-0.510，P <0.05）。TG、心外膜脂肪组织厚度是 血管舒张功能的独立影响因素（P <0.05）。结论 随着病程的增加，T2DM 患者的心外膜脂肪组织增加、内皮 功能受损加重，应用超声技术可以无创、简便地评价T2DM 患者心外膜脂肪组织及与内皮功能的关系。

Abstract:

Objective To evaluate the thickness of epicardial adipose tissue (EAT) of the patients with type 2 diabetes mellitus (T2DM) by ultrasonography and its correlation with endothelial function. Methods Totally 120 cases of T2DM patients were enrolled and divided into two groups: the course of disease was less than or equal 10 years (group B), the course of disease was more than 10 years (group C) and 60 healthy volunteers were enrolled as normal controls (group A). Ultrasonograhy was used to measure the EAT thickness and the endothelium-dependent flow-mediated vasodilation (FMD) of the right brachial artery, and the related clinical and laboratory indexes were obtained. Results The duration of diabetes mellitus, glycosylated hemoglobin, triglyceride and low density lipoprotein in the group C were higher than those in the group B (P < 0.05). The thickness of EAT in the group C and the group B were higher than those in the group A (P < 0.05), and the vasodilation function in group B and group C was lower than that in the group A (P < 0.05). Vasodilation function was negatively correlated with age, course of diabetes, glycated hemoglobin, total cholesterol, triglyceride, low density lipoprotein, epicardial adipose tissue thickness, C-peptide and fasting blood glucose (r = 0.333, -0.743, -0.705, -0.443, -0.819, -0.556, -0.761, -0.400 and- 0.510, P < 0.05). TG and epicardial adipose tissue thickness were independent influencing factors of vasodilation (P < 0.05). Conclusions With increase of the duration of diabetes, the EAT thickness increased and the endothelial function decreased. The correlation between EAT and the endothelial function in the T2DM patients can be evaluated by ultrasonography non-invasively and conveniently.