目的 研究不同程度的腹型肥胖对2型糖尿病(T2DM)患者心脏功能和结构的影响.方法 以CT测量腹内脂肪面积/皮下脂肪面积评价90例T2DM患者腹型肥胖的程度,以其腹型肥胖程度将受试者分为A组(n=44)和B组(n=46),以彩色多普勒超声心动图评价其左心室收缩、舒张功能及心脏结构改变,比较其心脏功能和结构方面的差异.结果 腹型肥胖程度不同的2组T2DM患者,在年龄、发病时间、BMI、心率、收缩压、舒张压、三酰甘油等比较,差异无统计学意义(P>0.05).B组左心室舒张早期充盈峰值流速(E峰)低于A组的平均水平,而其左心室舒张晚期充盈峰值流速(A峰)高于对照组平均水平(P<0.05),其E/A较A组显著降低;但左心室收缩功能(左心室射血分数)及心脏结构均差异无统计学意义(P>0.05).结论 腹型肥胖程度更严重的T2DM患者,其左心室舒张功能低于肥胖程度较轻的患者,腹型肥胖加重了T2DM患者的心血管风险.
Objective To investigate the effects of different degrees of abdominal obesity on cardiac function and structure of patients with type 2 diabetes mellitus (T2DM).Methods Spiral CT was used to measure the intraabdominal fat area and subcutaneous fat area,and a total of 90 patients with T2DM,who were divided into group A (n =44) and group B (n =46) according to the degrees of abdominal obesity.Color Doppler echocardiography was performed to evaluate the systolic function and diastolic function of left ventricular as well as the changes of cardiac structure to compare the differences between the two groups.Results The were no significant differences in age,disease time,body mass index (BMI),heart rate,systolic pressure,diastolic pressure and blood levels of triglyceride between the two groups (P > 0.05).The levels of early diastolic peak flow velocity (EPFV,E peak) in group B were significantly lower than those in group A (P < 0.05),however,the levels of atrial peak flow velocity (APFV,A peak) in group B were significantly higher than those in control group (P < 0.05),moreover,the ration of E/A in group B was significantly decreased,as compared with that in group A (P < 0.05).There were no significantly differences in left ventricular systolic function (left ventricular ejection fraction) and cardiac structure between the two groups (P > 0.05).Conclusion The left ventricular diastolic function in T2DM patients with more severe abdominal obesity is lower than that in T2DM patients with mild abdominal obesity,which suggests that abdominal obesity increases the cardiovascular disease risk of patients with T2DM.