视黄醇结合蛋白4和葡萄糖-6-磷酸异构酶与糖尿病分型、并发症的相关性

发布时间：2018-01-19 10:50

本文关键词： 型糖尿病(TDM) 型糖尿病(TDM) 糖尿病并发症葡萄糖--磷酸异构酶(GPI) 视黄醇结合蛋白(RBP)　出处：《中国老年学杂志》2016年09期 　论文类型：期刊论文

【摘要】：目的探讨视黄醇结合蛋白(RBP)4和葡萄糖-6-磷酸异构酶(GPI)与糖尿病(DM)并发症发生发展及DM分型的相关性。方法选取2010年2月至2012年8月在武汉科技大学附属天佑医院内分泌科240例住院和门诊病人,健康体检者160例。按要求随机分为6组,即正常人群组、单纯肥胖人群组、单纯1型糖尿病(T1DM)组、肥胖T2DM组、肥胖2型糖尿病(T2DM)合并相应并发症(肾病、大血管病变、视网膜病变)组、T2DM合并感染(急性呼吸道感染、急性泌尿系感染)组,各组80例,采用酶联免疫吸附试验(ELISA)方法分别检测正常人群组、单纯肥胖人群组、T2DM组、T2DM合并相应并发症(肾、大血管病变、视网膜病变)组四组RBP4含量。比较正常人群组、T2DM组、T1DM组、DM合并感染组GPI含量。检测各组研究对象检测空腹血糖(FBG)、餐后2 h血糖(2 h BG)、糖化血红蛋白(Hb A1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、舒张压(DBP)、体重指数(BMI),并分别分析与RBP4的相关性。结果 1单纯肥胖人群组与正常人群组RBP4含量均在正常范围,前者较后者RBP4含量增加(t=6.70,P0.01)。T2DM患者与肥胖患者比较RBP4含量增加(t=7.14,P0.01)。T2DM合并相应并发症时RBP4含量明显增加,与T2DM无并发症者比较差异显著(t=6.38,P0.01);2T2DM组、T1DM组GPI含量均较正常人群组高(t=15.37,t=11.90,P0.01),T1DM组比T2DM组GPI含量有增高趋势,但两组间无显著差异(t=6.13,P=0.56)。一旦DM合并感染,如呼吸道感染、泌尿系感染时,与非感染T2DM患者比较,GPI含量增高明显(t=12.76,P0.01)。3高血糖、高血压、血脂异常、体重增加均与RBP4显著相关;T2DM组RBP4与GPI的相关性不强。结论糖代谢异常、血压血脂异常、体重增加等与RBP4相关,RBP4也许可作为正常人进展为T2DM以及进一步并发慢性并发症的动态监测指标;GPI尚不能作为T1DM与T2DM鉴别的标志分子,也许可作为DM合并急性炎症感染的判断指标。
[Abstract]:Objective to investigate the relationship between retinol binding protein (RBP4) and glucose-6-phosphate isomerase (GPI) and diabetes mellitus (DM). Methods from February 2010 to August 2012, 240 inpatients and outpatients in the Endocrinology Department of Tianyou Hospital affiliated to Wuhan University of Science and Technology were selected. 160 healthy persons were randomly divided into 6 groups: normal group, simple obese group, type 1 diabetes T1DM group and obese T2DM group. Obesity type 2 diabetes mellitus (T2DM) with corresponding complications (nephropathy, macroangiopathy, retinopathy) group T2DM complicated with infection (acute respiratory tract infection, acute urinary tract infection) group. 80 cases in each group were detected by Elisa method. The normal group and simple obese group were divided into two groups: T2DM group and T2DM group with corresponding complications (kidney, macroangiopathy). The content of RBP4 in the four groups of the retinopathy group was compared with that in the normal group of T2DM group and T1DM group with infection group. The fasting blood glucose level was detected in each group. 2 h postprandial blood glucose and 2 h BGN, glycosylated hemoglobin (HbA1cU), total cholesterol (TCX), triglyceride (TGN), low density lipoprotein cholesterol (LDL-C). Systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI). Results 1 the content of RBP4 in the simple obese group and the normal group were in the normal range, and the RBP4 content in the former group was higher than that in the latter group, and the content of RBP4 in the former group was increased by 6.70% than that in the latter group. Compared with obese patients, the content of RBP4 in patients with P0.01U. T2DM was higher than that in obese patients. The content of RBP4 in patients with P0.01M / T2DM was significantly higher than that in patients with obesity. There was a significant difference between T2DM and T2DM without complications (P 0.01). 2the content of GPI in T2DM group was higher than that in normal group (P 0.01). The GPI content in T1DM group was higher than that in T2DM group, but there was no significant difference between the two groups. Once DM co-infected, such as respiratory tract infection, urinary tract infection, there was no significant difference between the two groups. Compared with non-infected T2DM patients, the increase of GPI level was significantly correlated with RBP4, hyperglycemia, hypertension, dyslipidemia and weight gain. Conclusion abnormal glucose metabolism, abnormal blood pressure and blood lipids, weight gain and so on are related to RBP4. RBP4 may be used as a dynamic monitoring index for the progression to T2DM and the further development of chronic complications in normal subjects. GPI can not be used as a marker for differential diagnosis between T1DM and T2DM, and may be used as a marker for the diagnosis of DM complicated with acute inflammatory infection.
【作者单位】：武汉科技大学附属天佑医院检验科;武汉科技大学附属天佑医院内分泌科;
【基金】：湖北省教育厅重点科研项目(No.D20101109) 湖北省教育厅教学项目(No.2008008) 武汉科技大学引进人才科研启动基金(530012)
【分类号】：R587.2
【正文快照】： 明确糖尿病(DM)分型、并发症发生及其程度是有效治疗DM的保障。目前,DM的流行状况正发生着变化,2型糖尿病(T2DM)呈现年轻化,发病率逐年攀升,临床上存在分型混乱和分型不清的现象〔1〕。DM并发症日益严重地威胁着患者的生存质量,当今研究多认为DM患者处于一种慢性、低度、非感

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