人血清胎盘生长因子（PLGF）与2型糖尿病及其大血管并发症关系的研究
发布时间：2019-04-13 18:43
【摘要】：目的:探究血清胎盘生长因子(plasma placental growth factor,PLGF)与2型糖尿病及相关大血管并发症之间的关系,通过分析PLGF与炎症反应、糖脂代谢的相关性,探讨PLGF作为2型糖尿病大血管并发症早期预测因子,以及作为治疗靶点的可能性。方法:根据有无2型糖尿病大血管并发症,将58例2型糖尿病患者分为单纯2型糖尿病组(T2DM组28例)和2型糖尿病合并大血管并发症组(T2DM+MVC组30例)。根据大血管病变的入选标准,选取相同时间于我院心内科和神经内科住院治疗的单纯动脉粥样硬化患者30例(MVC组)。正常对照组(NGT组24例)来自相同时间于我院健康查体者。对所有研究对象的既往史和近期用药史进行问诊,同时测量其身高、体重、计算体重指数BMI,检测其空腹血糖(FPG)、超敏C反应蛋白(hs-CRP)、血清甘油三酯(TG)、血清总胆固醇(TC)、血清高密度脂蛋白胆固醇(HDL-C)、血清低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(Hb A1c)、空腹C肽。对全部研究对象另单独留取一份血清标本,应用ELISA法检测其血清PLGF水平。结果:(1)T2DM、MVC、T2DM+MVC组血清PLGF水平(13.99±6.62,17.67±7.44,41.37±8.65)pg/ml均高于NGT组(9.67±6.59)pg/ml(P0.01),T2DM+MVC组血清PLGF水平又明显高于T2DM组和MVC组(P0.01),T2DM与MVC组血清PLGF水平差异无统计学意义(P=0.06)。(2)四组血清PLGF水平与FPG、TC、TG、Hb A1c、hs-CRP呈正相关(r分别为0.486、0.300、0.217、0.427、0.519,P0.05);2型糖尿病患者血清PLGF水平与hs-CRP、TC、LDL-C呈正相关(r分别为0.444、0.390、0.278,P0.05),与空腹C肽呈负相关(r=-0.332,P0.05);动脉粥样硬化患者血清PLGF水平与FPG、Hb A1c、hs-CRP呈正相关(r分别为0.661、0.625、0.352,P0.05)。(3)Logistic回归分析提示,PLGF、LDL-C、hs-CRP是动脉粥样硬化的危险因素,HDL-C是动脉粥样硬化的保护因素。结论:(1)在单纯2型糖尿病患者及单纯动脉粥样硬化患者,血清PLGF水平较正常人升高,而2型糖尿病并发大血管并发症的患者其血清PLGF水平进一步升高,结合血清PLGF水平与hs-CRP呈正相关,表明在2型糖尿病及动脉粥样硬化发病过程中,PLGF可能通过参与炎症反应促进糖尿病及其大血管并发症的发生、发展。因此,PLGF可能成为2型糖尿病大血管并发症的一个早期预测指标,同时也为早期干预提供一个新的可能的切入点。(2)PLGF与空腹血糖、多种血脂成分、hs-CRP呈正相关,因此通过降糖、调脂、控制体重等方法,可能使血清PLGF水平降低,从而延缓糖尿病及其大血管并发症的发生、发展,减少威胁生命的心脑血管事件的发生。
[Abstract]:Objective: to investigate the relationship between serum placental growth factor (plasma placental growth factor,PLGF) and type 2 diabetes mellitus and related macrovascular complications, and to analyze the relationship between PLGF and inflammation, glucose and lipid metabolism. To explore the possibility of PLGF as an early predictor of macrovascular complications in type 2 diabetes mellitus and as a therapeutic target. Methods: according to the macrovascular complications of type 2 diabetes mellitus, 58 patients with type 2 diabetes mellitus were divided into two groups: type 2 diabetes mellitus group (T2DM group, 28 cases) and type 2 diabetes mellitus complicated with macrovascular complication group (T2DM MVC group, 30 cases). According to the selected criteria of macroangiopathy, 30 patients with simple atherosclerosis (MVC group) who were hospitalized in our department of cardiology and neurology at the same time were selected. Normal control group (NGT group 24 cases) from the same time in our hospital health check-up. At the same time, height and weight were measured, fasting blood glucose (FPG), hypersensitive C-reactive protein (hs-CRP) and serum triglyceride (TG),) were measured by body mass index (BMI,). Serum total cholesterol (TC), serum high density lipoprotein cholesterol (HDL-C), serum low density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (Hb A1c), fasting C peptide. A single serum sample was collected from all subjects, and the serum PLGF level was measured by ELISA method. Results: (1) the serum PLGF level in T2DM, MVC, T2DM MVC group (13.99 卤6.62, 17.67 卤7.44, 41.37 卤8.65) pg/ml was higher than that in NGT group (9.67 卤6.59) pg/ml (P0.01). The level of serum PLGF in T2DM MVC group was significantly higher than that in T2DM group and MVC group (P0.01). There was no significant difference in serum PLGF level between T2DM group and MVC group (P < 0.01). There was no significant difference in serum PLGF level and FPG,TC,TG,Hb A1c between T2DM group and MVC group (P < 0.01). Hs-CRP was positively correlated (r = 0.486,0.300,0.217,0.427,0.519, P0.05). Serum PLGF level was positively correlated with hs-CRP,TC,LDL-C (r = 0.444, 0.390, 0.278, P0.05) and negatively correlated with fasting C-peptide (r = 0.332, P0.05) in type 2 diabetic patients. There was a positive correlation between serum PLGF level and FPG,Hb A1c, hsc CRP (r = 0.661, 0.625, 0.352, P0.05). (3) Logistic regression analysis showed that PLGF,LDL-C,hs-CRP was a risk factor for atherosclerosis. HDL-C is a protective factor of atherosclerosis. Conclusion: (1) the level of serum PLGF in patients with type 2 diabetes mellitus and simple atherosclerosis is higher than that in normal controls, and the level of serum PLGF in patients with macrovascular complications of type 2 diabetes mellitus is further higher than that in patients with type 2 diabetes mellitus. Combined with the positive correlation between serum PLGF level and hs-CRP, it is suggested that PLGF may promote the occurrence and development of diabetes mellitus and its macrovascular complications by participating in inflammatory reaction in the pathogenesis of type 2 diabetes and atherosclerosis. Therefore, PLGF may be an early predictor of macrovascular complications in type 2 diabetes mellitus and provide a new possible entry point for early intervention. (2) PLGF is positively correlated with fasting blood glucose, various lipid components, and hs-CRP. Therefore, by means of reducing blood sugar, regulating blood fat and controlling body weight, the level of serum PLGF may be reduced, thereby delaying the occurrence and development of diabetes mellitus and its macrovascular complications and reducing the occurrence of life-threatening cardiovascular and cerebrovascular events.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2
本文编号：2457830
[Abstract]:Objective: to investigate the relationship between serum placental growth factor (plasma placental growth factor,PLGF) and type 2 diabetes mellitus and related macrovascular complications, and to analyze the relationship between PLGF and inflammation, glucose and lipid metabolism. To explore the possibility of PLGF as an early predictor of macrovascular complications in type 2 diabetes mellitus and as a therapeutic target. Methods: according to the macrovascular complications of type 2 diabetes mellitus, 58 patients with type 2 diabetes mellitus were divided into two groups: type 2 diabetes mellitus group (T2DM group, 28 cases) and type 2 diabetes mellitus complicated with macrovascular complication group (T2DM MVC group, 30 cases). According to the selected criteria of macroangiopathy, 30 patients with simple atherosclerosis (MVC group) who were hospitalized in our department of cardiology and neurology at the same time were selected. Normal control group (NGT group 24 cases) from the same time in our hospital health check-up. At the same time, height and weight were measured, fasting blood glucose (FPG), hypersensitive C-reactive protein (hs-CRP) and serum triglyceride (TG),) were measured by body mass index (BMI,). Serum total cholesterol (TC), serum high density lipoprotein cholesterol (HDL-C), serum low density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (Hb A1c), fasting C peptide. A single serum sample was collected from all subjects, and the serum PLGF level was measured by ELISA method. Results: (1) the serum PLGF level in T2DM, MVC, T2DM MVC group (13.99 卤6.62, 17.67 卤7.44, 41.37 卤8.65) pg/ml was higher than that in NGT group (9.67 卤6.59) pg/ml (P0.01). The level of serum PLGF in T2DM MVC group was significantly higher than that in T2DM group and MVC group (P0.01). There was no significant difference in serum PLGF level between T2DM group and MVC group (P < 0.01). There was no significant difference in serum PLGF level and FPG,TC,TG,Hb A1c between T2DM group and MVC group (P < 0.01). Hs-CRP was positively correlated (r = 0.486,0.300,0.217,0.427,0.519, P0.05). Serum PLGF level was positively correlated with hs-CRP,TC,LDL-C (r = 0.444, 0.390, 0.278, P0.05) and negatively correlated with fasting C-peptide (r = 0.332, P0.05) in type 2 diabetic patients. There was a positive correlation between serum PLGF level and FPG,Hb A1c, hsc CRP (r = 0.661, 0.625, 0.352, P0.05). (3) Logistic regression analysis showed that PLGF,LDL-C,hs-CRP was a risk factor for atherosclerosis. HDL-C is a protective factor of atherosclerosis. Conclusion: (1) the level of serum PLGF in patients with type 2 diabetes mellitus and simple atherosclerosis is higher than that in normal controls, and the level of serum PLGF in patients with macrovascular complications of type 2 diabetes mellitus is further higher than that in patients with type 2 diabetes mellitus. Combined with the positive correlation between serum PLGF level and hs-CRP, it is suggested that PLGF may promote the occurrence and development of diabetes mellitus and its macrovascular complications by participating in inflammatory reaction in the pathogenesis of type 2 diabetes and atherosclerosis. Therefore, PLGF may be an early predictor of macrovascular complications in type 2 diabetes mellitus and provide a new possible entry point for early intervention. (2) PLGF is positively correlated with fasting blood glucose, various lipid components, and hs-CRP. Therefore, by means of reducing blood sugar, regulating blood fat and controlling body weight, the level of serum PLGF may be reduced, thereby delaying the occurrence and development of diabetes mellitus and its macrovascular complications and reducing the occurrence of life-threatening cardiovascular and cerebrovascular events.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2
【参考文献】
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1 贾伟平,项坤三;胰岛β细胞功能评估——从基础到临床[J];中华内分泌代谢杂志;2005年03期
，本文编号：2457830
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