二维斑点追踪超声心动图评估高脂血症对2型糖尿病患者右室功能的影响及心室相互关系分析

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ABSTRACTObjectiveToassessthe impactof hyperlipidemia（HLP）onright ventricular function inpatients with type2diabetes melitus（T2DM）by two-dimensional speckle trackingechocardiography（2D-STE），and toanalyzethe interrelationshipbetweenrightandleftventricularfunction.MethodsAtotalof118T2DMpatients treatedinourhospital were enrolled and divided into a HLP group（ n =67）and a non-HLP group（NHLP group，n=51）.Additionally，5O healthy individuals during thesame period were selectedasthenormalcontrolgroup.Thefasting plasma glucose（FPG），glycosylatedhemoglobin （HbAlc），totalcholesterol（TC），triglycerides（TG），low-densitylipoproteincholesterol（LDL-C），ndhig-densitylopotei cholesterol（HDL-C）werecolected.2D-STE wasused toobtain left ventricularglobal longitudinal strain（LVGLS），left ventricular globalcircumferentialstrain（LVGCS），ightventricular globallongitudinalstrain（RVGLS），andrightventricular free-wall longitudinal strain （RVFWLS）.The differences inabove parametersamong thegroups werecompared.Pearson correlation analysis was performed toanalyze thecorrelations between RVFWLS，RVGLSandLVGLS，LVGCS，TC，TG，HDL-C， andLDL-C.Multiple linearregression wasusedtoanalyze theefectsof TGandLVGLSonrightventricularfunction（RVGLS） inT2DMpatients.Mediationanalysisusing thecausal-stepregresion method（Baron-Kennyapproach）wasconducted，with LVGLS includedas a mediator to assess whether LVGLS mediatesthe effectofTGonRVGLS.ResultsThe FPGand HbAlc in the NHLP group and HLP group were both higherthanthose in the normalcontrol group，TC，TG，andLDL-Cinthe HLP group werehigherthanthoseinboththenormalcontrolgroupandtheNHLPgroup，withstatisticallysignificantdiferences（all P <0.05）. RVFWLS，RVGLS，and LVGLS decreased progresivelyinthe normal control，NHLP，and HLP groups，withsignificant differences in pairwise comparison（all P <0.05）.Correlation analysis showed that RVFWLS was positively correlated with LVGLS andLVGCS，and negatively correlated with TC and TG（all P<0.01 ）.RVGLS was positively correlated with LVGLSand LVGCS， and negatively correlated with TC，TG，and LDL-C（all P<0.05 ）.Multiple linear regression and mediation analysis demonstrated that TG was independently negatively correlated with RVGLS（ β =-0.297，P

KEYWORDSSpeckle tracking echocardiography，two-dimensional;Type2diabetes melitus;Hyperlipidemia;Right ventricular function;Left ventricular function;Ventricularinterrelationship

2型糖尿病（type2diabetesmellitus，T2DM）是一种慢性代谢性疾病，其患病率逐年升高，预计2045年我国糖尿病患病数将增至1.744亿[1，已成为重大公共卫生问题。（剩余8928字）