Influencing factors for acute pancreatitis in patients with type 2 diabetes complicated by hypertriglyceridemia
-
摘要: 目的探讨2型糖尿病患者并发高甘油三酯血症与急性胰腺炎发生的关系,以指导糖尿病患者急性胰腺炎的预防和治疗。方法选取2013年1月-2016年12月榆林市第一医院收治的2型糖尿病并发急性胰腺炎患者46例为试验组,另选取本院同期收治的单纯2型糖尿病患者52例为对照组。记录患者的年龄、性别、糖尿病病程、身高、体质量、腹围、吸烟、饮酒、胆结石、高血压、血糖、血脂情况[TC、TG、HDL-C、LDL-C]。检测患者糖尿病相关并发症的发生情况。计数资料2组间比较采用χ2检验,计量资料2组间比较采用t检验;采用logistic回归进行多因素分析。结果 2组患者在年龄、性别构成、身高、体质量、腹围、吸烟饮酒习惯、高血压、胆结石、糖尿病病程等方面的差异无统计学意义(P值均>0.05);试验组患者的TC、TG、LDL-C水平均显著高于对照组,差异均有统计学意义(t值分别为5.122、4.127、3.524,P值分别为<0.01、<0.01、0.012),对照组患者的HDL-C水平显著高于试验组,差异统计学意义(t=2.231,P=0.037);试验组患者的糖尿病微血管病变(糖尿病视网膜病变...Abstract: Objective To investigate the association between hypertriglyceridemia and acute pancreatitis in patients with type 2 diabetes, in order to guide the prevention and treatment of acute pancreatitis in patients with diabetes. Methods A total of 46 patients with type 2 diabetes complicated by acute pancreatitis who were admitted to The First Hospital of Yulin from January 2013 to December 2016 were enrolled as study group, and 52 patients with type 2 diabetes alone who were admitted to our hospital within the same period of time were enrolled as control group. Related data were recorded, including age, sex, course of diabetes, body height and weight, abdominal circumference, smoking, drinking, gallstones, hypertension, blood glucose, and blood lipids [total cholesterol ( TC) , triglyceride ( TG) , high-density lipoprotein cholesterol ( HDL-C) , and low-density lipoprotein cholesterol ( LDL-C) ]. The incidence rates of complications associated with diabetes were analyzed. The chi-square test was used for comparison of categorical data ( general status, blood lipids, and diabetic complications) between two groups; and the t-test was used for comparison of such data between two groups. A logistic regression analysis was used for multivariate analysis. Results There were no significant differences between the two groups in age, sex composition, body height and weight, abdominal circumference, smoking and drinking habits, hypertension, gallstones, and course of diabetes ( all P >0. 05) . The study group had significantly higher levels of TC, TG, and LDL-C than the control group ( t = 5. 122, 4. 127, and 3. 524, P < 0. 01, < 0. 01, and = 0. 012) , while the control group had a significantly higher level of HDL-C than the study group ( t = 2. 231, P = 0. 037) . The study group had a significantly higher incidence rate of diabetic microangiopathy ( diabetic retinopathy and chronic diabetic nephropathy) than the control group ( χ2= 92. 126, P < 0. 01) . The multivariate analysis showed that compared with those with a normal TG level, the type 2 diabetic patients with a high TG level had a risk of acute pancreatitis increased by 47. 6% ( odds ratio [OR]= 1. 476, P =0. 031) , and the type 2 diabetic patients with a high LDL-C level had a risk of acute pancreatitis increased by 48. 7% ( OR = 1. 487, P =0. 045) . Conclusion Blood lipids should be measured for patients with type 2 diabetes, and blood glucose and blood lipid levels should be actively controlled for patients with type 2 diabetes complicated by hypertriglyceridemia, in order to reduce the incidence rate of acute pancreatitis.
-
Key words:
- diabetes mellitus, type 2 /
- hypertriglyceridemia /
- pancreatitis /
- risk factors
-
[1]Professional Committee of Pancreatic Disease, Chinese Medical Doaor Association.Chinese consensus on the multidisciplinary treatment (MDT) of acute pancreatitis[J].J Clin Hepatol, 2015, 31 (11) :1770-1775.中国医师协会胰腺病学专业委员会.中国急性胰腺炎多学科诊治共识意见[J].临床肝胆病杂志, 2015, 31 (11) :1770-1775. [2]QU FZ, CAO CL, WANG G, et al.Role of programmed cell necrosis in occurrence and development of acute pancreatitis[J].Chin JDig Surg, 2016, 15 (11) :1127-1130. (in Chinese) 曲凤智, 曹成亮, 王刚, 等.程序性坏死在急性胰腺炎发生发展中的作用[J].中华消化外科杂志, 2016, 15 (11) :1127-1130. [3]HU WL.Risk factors for hypertriglyceridemia-induced acute pancreatitis[J].J Clin Hepatol, 2017, 33 (8) :1518-1521. (in Chinese) 胡维林.高甘油三脂血症相关性急性胰腺炎发病的危险因素分析[J].临床肝胆病杂志, 2017, 33 (8) :1518-1521. [4]PAN G, CHEN YF, CAI J, et al.The clinical value of clinical characteristics and prognosis of elderly patients with hyperlipidemic acute pancreatitis[J].Chin J Med Offic, 2016, 44 (6) :579-582. (in Chinese) 潘刚, 陈亚峰, 蔡杰, 等.老年高脂血症性急性胰腺炎临床特点及预后评估因素分析[J].临床军医杂志, 2016, 44 (6) :579-582. [5]National Associated Group for acute pancreatitis.Etiology and mortality of acute pancreatitis in China:analysis of 6 223 clinical cases[J].Chin J Pancreatol, 2006, 6 (6) :321-325. (in Chinese) 急性胰腺炎协作组.中国6223例急性胰腺炎病因及病死率分析[J].中华胰腺病杂志, 2006, 6 (6) :321-325. [6]Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association, Editorial Board of Chinese Journal of Pancreatology, Editorial Board of Chinese Journal of Digestion.Chinese guidelines for the management of acute pancreatitis (Shanghai, 2013) [J].J Clin Hepatol, 2013, 29 (9) :656-660. (in Chinese) 中华医学会消化病学分会胰腺疾病学组.中国急性胰腺炎诊治指南 (2013年, 上海) [J].临床肝胆病杂志, 2013, 29 (9) :656-660. [7]YAN T, LI LL, WANG HM, et al.Correlation between adipocytokines levels and metabolic syndrome in type 2 diabetes mellitus[J].J South Med Univ, 2014, 34 (2) :275-278. (in Chinese) 严婷, 李玲玲, 王怀明, 等.脂肪细胞因子与代谢综合征在2型糖尿病中的关系研究[J].南方医科大学学报, 2014, 34 (2) :275-278. [8]AMANMEET G, DA X, ANDREW PB.Statistical validation of wavelet transform coherence method to assess the transfer of calf muscle activation to blood pressure during quiet standing[J].Biomed Eng Online, 2013, 12 (1) :132. [9]NOEL RA, BRAUN DK, PATTERSON RE, et al.Increased risk of acute pancreatiti S and biliary disease observed in patients with type 2 diabetes[J].Diabetes Care, 2011, 32 (5) :834-838. [10]SAWIRES HK, MOHAMED WA, SCHAALAN MF.High-flux and Low-flux dialysis membranes and level S of intercellular adhesion molecule-l and vascular cell adhesion molecule-1 in children with chronic kidney failure[J].Iran J Kidney Dis, 2012, 6 (5) :366-372. [11] BERGLUND L, BRUNZELL JD, GOLDBERG AC, et al.Evaluation and treatment of hypertriglyceridemia:an Endocrine Society clinical practice guideline[J].J Clin Endocrinol Metab, 2012, 97 (9) :2011-3213. [12]GUBENSEK J, BUTUROVIC PONIKVAR J, MARNN PERNAT A, et al.Treatment of hyperlipidemic acute pancreatitis with plasma exchange:a single-center experience[J].Ther Apher Dial, 2011, 13 (4) :314-317. [13]XIA J, XIE XN, GANG XK, et al.Progress research on individualized treatment of senile patientswith diabetes[J].J Jilin Univ:Medcine Edition, 2016, 42 (1) :191-194. (in Chinese) 夏君, 谢晓娜, 刚晓坤, 等.老年糖尿病患者个体化治疗的研究进展[J].吉林大学学报:医学版, 2016, 42 (1) :191-194. [14]SALIGRAM S, LO D, SAUL M, et al.Analyses of hospital administrative data that use diagnosis codes overestimate the cases of acute pancreatitis[J].Clin Gastroenterol Hepatol, 2012, 10 (7) :805-811. [15]LAI SW, MUO CH, LIAO KF, et al.Risk of acute pancreatitis in type 2 diabetes and risk reduction on anti-diabetic drugs:a population-based cohort study in Taiwan[J].Am J Gastroenterol, 2011, 106 (9) :1697-1704. [16]BERGLUND L, BRUNZELL JD, GOLDBERG AC, et al.Evaluation and treatment of hypertriglyceridemia:an Endocrine Society clinical practice guideline[J].J Clin Endocrinol Metab, 2012, 97 (9) :2011-3213. [17]ZHANG W, ZHAO Y, ZENG Y, et al.Hyperlipidemic versus normal---lipid acute necrotic pancreatitis:proteomicanalysis using an animal model[J].Pancreas, 2012, 41 (2) :317-322. [18]ZUO LT, CHEN J, ZHANG HR.Recent Developments in the Management of Hyperlipidemic Pancreatitis[J].Chin Gen Pract, 2017, 20 (9) :1141-1146. (in Chinese) 左丽婷, 陈建, 张海蓉.高脂血症性胰腺炎的研究进展[J].中国全科医学, 2017, 20 (9) :1141-1146. [19]LIU XY, LIU RX, YIN ZH.Expression and significance of classical ACE-Ang II-AT1 axis and new ACE2-Ang (1-7) -Mas axis of renin-angiotensin system in local pancreas[J].J Clin Hepatol, 2017, 31 (9) :1554-1557. (in Chinese) 刘晓亚, 刘瑞霞, 阴祯宏.胰腺局部肾素-血管紧张素系统经典轴ACE-Ang II-AT1及新轴ACE2-Ang (1-7) -Mas的表达及意义[J].临床肝胆病杂志, 2017, 31 (9) :1554-1557. [20]ZHU MD, LUO YQ.Research advances in integrated traditional Chinese and Western medicine therapy for severe acute pancreatitis[J].J Clin Hepatol, 2017, 33 (1) :188-193. (in Chinese) 朱美冬, 罗运权.中西医治疗重症急性胰腺炎的研究进展[J].临床肝胆病杂志, 2017, 33 (1) :188-193. [21]HAO TT, MA XP, WEN YL, et al.Changes in serum levels of M30, M65, and IL-17 and their clinical significance in patients with acute pancreatitis[J].J Clin Hepatol, 2016, 32 (2) :329-332. (in Chinese) 郝婷婷, 马晓鹏, 温彦丽, 等.急性胰腺炎患者血清M30、M65及白细胞介素17水平的变化及意义[J].临床肝胆病杂志, 2016, 32 (2) :329-332.
本文二维码
计量
- 文章访问数: 436
- HTML全文浏览量: 51
- PDF下载量: 162
- 被引次数: 0