2型糖尿病患者心肺耐量及其影响因素分析

关键词：2型糖尿病  心肺运动试验  心肺耐量  影响因素

Keywords:type 2 diabetes mellitus  cardiopulmonary exercise testing  cardiopulmonary fitness  influencing factors

摘要：

      摘要 目的：探究2型糖尿病（T2DM）患者的心肺耐量，分析心肺耐量的影响因素。 方法：2021年1月至2022年12月，对接受心肺运动试验（CPET）评估的169例T2DM患者的病历资料进行回顾性分析，根据峰值摄氧量占预计值的百分比（peak VO2%），分为心肺耐量正常组及心肺耐量减低组。采用单因素分析比较两组间临床资料的差异，采用 Logistic回归筛选心肺耐量减低的影响因素。 结果：共纳入病例169例，其中心肺耐量正常组48例，减低组121例。多因素Logistic回归分析显示，体重指数、高血压病史、冠心病病史、糖化血红蛋白、胰岛素抵抗指数、体育锻炼习惯是T2DM心肺运动耐量的影响因素（OR=1.278、5.159、3.876、2.911、2.586、0.086，P<0.05）。 结论：T2DM患者普遍存在心肺耐量减低；体重指数、糖化血红蛋白水平、胰岛素抵抗指数、高血压病史、冠心病病史是心肺耐量减低的独立危险因素，规律体育锻炼是保护因素。

Abstract:

      Abstract Objective：To evaluate cardiopulmonary exercise fitness in patients with type 2 diabetes mellitus （T2DM） and investigate its influencing factors and possible mechanism. Method：A retrospective analysis was conducted on the medical records of 169 patients with T2DM who underwent cardiopulmonary exercise testing (CPET) from January 2021 to December 2022. Cardiopulmonary fitness was evaluated by peak oxygen consumption（peak VO2）value in CPET. Patients were divided into cardiopulmonary fitness normal group and abnormal group according to peak VO2 % value in CPET．Univariate analysis was used to compare the differences in clinical data between the two groups， and multivariate Logistic regression analysis was used to screen the independent influencing factors to construct risk prediction. Result：A total of 169 cases were included， with 48 cases in the cardiopulmonary fitness normal group and 121 cases in the abnormal group. Multivariate Logistic regression analysis showed that body mass index，history of hypertension，history of heart disease，glycated hemoglobin level， insulin resistance index and physical exercise were independent influencing factors for the exercise fitness in T2DM （OR=1.278，5.159，3.876，2.911，2.586，0.086，all P<0.05）. Conclusion：Cardiopulmonary fitness is commonly reduced in patients with T2DM. Body mass index， glycated hemoglobin level， insulin resistance index，history of hypertension，history of heart disease are independent risk factors for declined cardiopulmonary fitness. While regular physical exercise is a protective factor.