新诊断肥胖2型糖尿病患者的相关影响因素分析

Analysis of influencing factors in obese patients with newly diagnosed type-2 diabetes mellitus

摘要:

目的：探讨新诊断肥胖2型糖尿病患者的相关影响因素。方法：收集2017年12月至2018年6月在重庆市第五人民医院内分泌科住院的新诊断2型糖尿病患者157例为研究对象，以WHO-西太平洋区成人肥胖诊断标准，即体质指数（body mass index，BMI）25 kg/m2为切点分为非肥胖组87例，肥胖组70例，分析新诊断肥胖2型糖尿病患者的常规生化指标。结果：肥胖组年龄（P=0.014）、高密度脂蛋白胆固醇（high density lipoprotein cholesterol，HDL-C）（P=0.036）、总胆汁酸（total bile acid，TBA）（P=0.010）均低于非肥胖组，差异有统计学意义。Spearman相关分析显示，年龄（r=-0.191，P=0.017）、TBA（r=-0.211，P=0.008）与2型糖尿病肥胖发病呈负相关，C反应蛋白（C-reactive protein，CRP）（r=0.178，P=0.027）与2型糖尿病肥胖发病呈正相关，差异有统计学意义。二元logistic回归分析显示，TBA（OR=0.551，95%CI=0.317~0.957，P=0.034）使2型糖尿病肥胖发病的风险降低了44.9%。结论：胆汁酸可能是新诊断肥胖2型糖尿病患者的独立保护因素。

Abstract:

Objective：To investigate the influencing factor in obese patients with newly diagnosed type-2 diabetes mellitus（T2DM）. Methods：From December 2017 to June 2018，a total of 157 patients with newly diagnosed T2DM in the endocrinology department from the Fifth People’s Hospital of Chongqing，were selected and divided into the obese group（n=70） and the non-obese group（n=87） according to different cut-offs for body mass index（BMI） of 25 kg/m2 on the basis of WHO-Western Pacific diagnostic criteria for adult obesity. The routine biochemical indexes of obese patients with newly diagnosed T2DM were compared and analyzed to explore the influencing factors. Results：Age（P=0.014），high density lipoprotein cholesterol（HDL-C）（P=0.036），and total bile acid（TBA） in the obese group（P=0.010） were lower than those in the non-obese group. Spearman correlation analysis showed that the onset of obe－sity in T2DM was negatively correlated with age（r=-0.191，P=0.017） and TBA（r=-0.211，P=0.008），and positively correlated with C-reactive protein（CRP）（r=0.178，P=0.027）. Binary logistic regression analysis showed that TBA（OR=0.551，95%CI=0.317-0.957，P=0.034） decreased the risk of the onset of obese in T2DM by 44.9%. Conclusion：Bile acid may be an independent protective factor for obese patients with newly diagnosed T2DM.