血清鸢尾素与2型糖尿病颈动脉粥样硬化的相关性

发布时间：2018-06-03 15:22

  本文选题：鸢尾素 + 糖尿病　； 参考：《上海医学》2017年08期

【摘要】：目的探讨2型糖尿病(T2DM)患者血清鸢尾素(Irisin)与颈动脉粥样硬化(CAS)的相关性。方法选择2014年7月—2015年10月于三峡大学仁和医院内分泌科住院的新诊断的T2DM患者92例,其中不合并CAS组(T2DM组)45例,合并CAS组(T2DM合并CAS组)47例;同期于门诊就诊的糖耐量正常的CAS患者(CAS组)46例和在体检中心经口服葡萄糖耐量试验(OGTT试验)排除T2DM的健康体检者(对照组)48名。受试者禁食8h后,测量其收缩压(SBP)、舒张压(DBP);于清晨抽取空腹肘静脉血,检测三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA_(1c))、TNF-α、人纤溶酶原激活物抑制剂1(PAI-1)、胰岛素、超氧化物歧化酶(SOD)、Irisin、空腹血糖(FPG)和餐后2h血糖(2hPG)水平,计算胰岛素抵抗指数(HOMA-IR),并测量颈动脉内膜中层厚度(IMT)。结果 4组间的性别构成、年龄、SBP、DBP的差异均无统计学意义(P值均0.05)。CAS组的TC、LDL-C、PAI-1、TNF-α、IMT,T2DM组的LDL-C、PAI-1、胰岛素、HOMA-IR、HbA_(1c)、TNF-α、IMT,T2DM合并CAS组的TG、TC、LDL-C、PAI-1、胰岛素、HOMA-IR、HbA_(1c)、TNF-α、IMT均显著高于对照组(P值分别0.05、0.01);CAS组的HDL-C、SOD,T2DM组HDL-C、SOD,T2DM合并CAS组的HDL-C、SOD均显著低于对照组(P值分别0.05、0.01)。T2DM组的胰岛素、HOMA-IR、HbA_(1c)均显著高于CAS组(P值分别0.05、0.01)。CAS组的LDL-C、IMT,T2DM合并CAS组的LDL-C、PAI-1、胰岛素、HOMA-IR、HbA_(1c)、TNF-α、IMT均显著高于T2DM组(P值分别0.05、0.01);T2DM合并CAS组的SOD显著低于T2DM组(P0.05)。对照组的血清Irisin水平显著高于其他3组(P值分别0.05、0.01),T2DM合并CAS组的血清Irisin水平显著低于CAS组和T2DM组(P值均0.05)。血清Irisin水平与LDL-C(r=-0.531,P=0.011)、FPG(r=-0.603,P=0.002)、2hPG(r=-0.596,P=0.006)、HbA_(1c)(r=-0.596,P=0.003)、TNF-ɑ(r=-0.597,P=0.003)、胰岛素(r=-0.521,P=0.014)、HOMA-IR(r=-0.552,P=0.011)、IMT(r=-0.639,P=0.001)、PAI-1(r=-0.591,P=0.007)均呈负相关,与HDL-C(r=0.597,P=0.006)、SOD(r=0.605,P=0.002)均呈正相关,与年龄、性别、SBP、DBP、TG、TC均不相关(P值均0.05)。以IMT为因变量,FPG、HbA_(1c)、HOMA-IR、SOD、TNF-α、Irisin、PAI-1等为自变量进行多元逐步回归分析,结果显示,Irisin(回归系数=-0.208,P=0.006)、HbA_(1c)(回归系数=9.321,P=0.022)为影响IMT的独立相关因素。回归方程:IMT=9.321×HbA_(1c)-0.208×Irisin-3.156。结论 CAS患者Irisin水平降低,Irisin与糖脂代谢、胰岛素抵抗、TNF-α、氧化应激、PAI-1关系密切,低水平的Irisin参与了CAS的发生,其机制值得进一步深入研究。
[Abstract]:Objective to investigate the relationship between serum Irisin (Irisin) and carotid atherosclerosis (CAS) in patients with type 2 diabetes mellitus (T2DM). Methods 92 newly diagnosed T2DM patients in Department of Endocrinology, Renhe Hospital, three Gorges University from July 2014 to October 2015 were selected, including 45 cases of T2DM without CAS and 47 cases of T2DM with CAS in CAS group. At the same time, 46 patients with normal glucose tolerance in CAS group and 48 healthy controls who were excluded from T2DM by oral glucose tolerance test (OGTT test) in the physical examination center. After fasting for 8 hours, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. Triacylglycerol (TGG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-CU), high density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA), human plasminogen activator inhibitor (HPA), human plasminogen activator inhibitor (PAI-1), insulin were detected. The levels of superoxide dismutase (SOD) Irisin, fasting blood glucose (FPG) and postprandial blood glucose (2 h) were calculated to calculate the insulin resistance index (HOMA-IRN), and the carotid intima-media thickness (IMT) was measured. Results the sex composition of the four groups, 骞撮緞,SBP,DBP鐨勫樊寮傚潎鏃犵粺璁″�︽剰涔�(P鍊煎潎0.05).CAS缁勭殑TC,LDL-C,PAI-1,TNF-伪,IMT,T2DM缁勭殑LDL-C,PAI-1,鑳板矝绱，

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