剪切波弹性成像技术定量评价合并高脂血症的2型糖尿病患者颈动脉弹性

Quantitative evaluation of carotid artery stiffness in patients with type 2 diabetes mellitus complicated by hyperlipidemia using shear wave elastography

摘要:

目的]应用剪切波弹性成像(SWE)技术定量评价合并高脂血症的2型糖尿病(T2DM)患者颈动脉弹性。 [方法]本研究纳入112例T2DM患者,根据是否合并高脂血症将其分为单纯糖尿病组(n＝52)和合并高脂血症组(n＝60),同时选择健康体检者作为对照组(n＝55)。收集各组的一般资料和生物化学指标。常规超声测量左侧颈总动脉内膜中膜厚度(IMT)、收缩期峰值血流速度(PSV)、收缩期末内径(Ds)及舒张期末内径(Dd),并计算管壁运动度(ΔD)和僵硬度系数(β)。应用SWE测量左侧颈总动脉弹性模量最大值的均值(ME_max)、平均值的均值(ME_mean)及最小值的均值(ME_min)。 [结果]单纯糖尿病组、合并高脂血症组空腹血糖(FBG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDLC)水平显著高于对照组,高密度脂蛋白胆固醇(HDLC)水平显著低于对照组(均P＜0.05)；合并高脂血症组TC、TG及LDLC水平显著高于单纯糖尿病组,HDLC水平显著低于单纯糖尿病组(均P＜0.05)。单纯糖尿病组、合并高脂血症组SWE参数(ME_max、ME_mean及ME_min)显著高于对照组(均P＜0.05),合并高脂血症组SWE参数均显著高于单纯糖尿病组(均P＜0.05)。Pearson相关分析显示,IMT、TC、TG、LDLC、FBG及HbA1c与SWE参数呈正相关,HDLC与SWE参数呈负相关(均P＜0.05)。多元线性回归分析表明,2型糖尿病和高脂血症是颈动脉SWE参数的独立危险因素(P＜0.05)。 [结论]高脂血症与T2DM患者颈动脉弹性的恶化显著相关,SWE技术能定量评估合并高脂血症的T2DM患者颈动脉弹性。

Abstract:

Aim To quantitatively evaluate carotid artery stiffness in patients with type 2 diabetes mellitus (T2DM) complicated by hyperlipidemia using shear wave elastography (SWE). Methods 112 T2DM patients were included in this study. They were divided into simple diabetes group (n＝52) and hyperlipidemia group (n＝60) according to whether they were combined with hyperlipidemia. At the same time, healthy people were selected as the control group (n＝55). General data and biochemical indices were collected for each group. Conventional ultrasound was used to measure the intima-media thickness (IMT), peak systolic velocity (PSV), systolic diameter (Ds) and diastolic diameter (Dd) of the left common carotid artery, and the wall motion amplitude (ΔD) and stiffness coefficient (β) were calculated. SWE was applied to measure the mean of the maximum modulus (ME_max), the mean of mean elastic modulus (ME_mean) and the mean of minimum modulus (ME_min) of the left common carotid artery. Results The levels of fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDLC) in the simple diabetes group and the hyperlipidemia group were significantly higher than those in the control group, while the levels of high density lipoprotein cholesterol (HDLC) were significantly lower than those in the control group (all P＜0.05); The levels of TC, TG and LDLC in the hyperlipidemia group were significantly higher than those in the simple diabetes group, and the HDLC levels were significantly lower than those in the simple diabetes group (all P＜0.05). SWE parameters (ME_max, ME_mean and ME_min) in the simple diabetes group and the hyperlipidemia group were significantly higher than those in the control group (all P＜0.05), and SWE parameters in the hyperlipidemia group were significantly higher than those in the simple diabetes group (all P＜0.05). Pearson correlation analysis showed that IMT, TC, TG, LDLC, FBG and HbA1c were positively correlated with SWE parameters (all P＜0.05), while HDLC was negatively correlated with SWE parameters (all P＜0.05). Multivariable linear regression analysis indicated that T2DM and hyperlipidemia were independent risk factors for carotid SWE parameters (both P＜0.05). ConclusionHyperlipidemia is significantly correlated with deterioration of carotid elasticity in T2DM patients, and SWE technology can quantitatively evaluate carotid elasticity in T2DM patients complicated with hyperlipidemia.