醫(yī)學(xué)免費(fèi)論文:超敏C-反應(yīng)蛋白及脂聯(lián)素與2型糖尿病大血管病變的相關(guān)性研究
[摘要]目的:分析2型糖尿病合并大血管病變與血清超敏C-反應(yīng)蛋白及脂聯(lián)素水平的相關(guān)性。方法:79例2型糖尿病患者,按有無大血管病變分為伴大血管病變組(A)40例,無大血管病變組(B組)39例。另選40例健康者作正常對(duì)照組(C組),均檢測(cè)血清超敏C-反應(yīng)蛋白,脂聯(lián)素及空腹血糖、空腹胰島素、血脂等指標(biāo)。結(jié)果:A組血清超敏C-反應(yīng)蛋白高于B組及C組(P<005),B組明顯高于C組(P<005),A組脂聯(lián)素水平明顯低于B組及C組(均P<005),B組明顯低于C組(P<005)。相關(guān)分析提示血清超敏C-反應(yīng)蛋白與脂聯(lián)素有相關(guān)性(P<005)。結(jié)論:超敏C-反應(yīng)蛋白,脂聯(lián)素對(duì)于2型糖尿病患者發(fā)生大血管病變的預(yù)測(cè)具有重要意義。
[關(guān)鍵詞]2型糖尿病;大血管病變;超敏C反應(yīng)蛋白;脂聯(lián)素
Association of ultrasensitive C-reactive protein and adiponectin with macrovascular complications in patients with type 2 diabetes mellitusBAI Hua,LIN Yang,WU Chun-fang (The Fourth People′s Hospital of Zhanjiang City,Zhanjiang524008,China)Abstract:ObjectiveTo explore the association of hypersensitivity C-reactive protein (hs-CRP) and adiponectin with macrovascular complications in patients with type 2 diabetes mellitus (DM)MethodThe 79 cases of type 2 diabetes mellitus were divided into two groups (40 cases with macrovascular process as group A and 39 cases without as group B),and 40 heathy subjects served as a control groupHs-CRP,adiponectin,fasting blood glucose (FBG),fasting insulin (FINS),serum lipid and other indicators were measuredResultsThe level of hs-CRP in group A was higher than that in group B and group C(P<005),and group B was significantly higher than that in group C (P<005)The level of adiponectin in group A was significantly lower than that in group B and C(P<005),and group B was lower than that in group C(P<005)Linear correlation analysis showed that there was association between the serum hs-CRP with adiponectin(P<005)ConclusionHs-CRP and adiponectin seem to be risk factors of type 2 diabetes and the macrovascular complication and plays an important role in risk prediction of type 2 DM patients with macrovascular complicationKey Words:Type 2 diabetes mellitus;Macrovascular complications;Hypersenditivity C-reactive protein;Adiponectin
2 型糖尿病(DM)是一種嚴(yán)重影響人類生命健康的疾病,其血管并發(fā)癥是其死亡和致殘的主要原因。近年來糖尿病炎癥學(xué)說備受關(guān)注,認(rèn)為DM是一種自然免疫和低底炎癥性疾病。C-反應(yīng)蛋白(CRP)是血管炎癥反應(yīng)的一個(gè)敏感指標(biāo)。脂聯(lián)素是一種由脂肪細(xì)胞合成、分泌的由244個(gè)氨基酸組成的脂肪特異蛋白,具有抗炎、抗動(dòng)脈硬化的作用。我們分析了2型糖尿病合并大血管病變及無大血管病變與超敏CRP(hs-CRP)、脂聯(lián)素的相關(guān)性,旨在探討2型糖尿病與慢性炎癥的關(guān)系醫(yī).學(xué).全.在.線m.gydjdsj.org.cn。
1對(duì)象與方法
11對(duì)象:2型DM 79例,均為我院就診患者,其中男49例,女30例,年齡55~75歲,均符合1999年WHO的2型糖尿病診斷標(biāo)準(zhǔn),排除急慢性感染性疾病,免疫性疾病及腫瘤患者。DM伴大血管病變組(A組)40例,男23例,女17例,年齡(525±106)歲,其中冠狀動(dòng)脈硬化者15例,腦動(dòng)脈硬化者11例,頸動(dòng)脈硬化者10例,既患冠狀動(dòng)脈硬化又患腦動(dòng)脈硬化者4例。2型DM無大血管病變組(B組)30例,男17例,女13例,年齡(502±125)歲。正常人群組(C組)30例,男14例,女16例,年齡(476±136)歲。各組在性別、年齡等方面差異無統(tǒng)計(jì)學(xué)意義(P<005),具有可比性。
12方法:所有研究對(duì)象均經(jīng)全身體檢及頸動(dòng)脈和雙下肢動(dòng)脈彩色多普勒超聲波和頭顱CT檢查。Hs-CRP采用北京利德曼生化技術(shù)有限公司產(chǎn)品。批內(nèi)CV 03%,批間CV 21%。甘油三酯(TG)、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)與低密度脂蛋白膽固醇(LDL-C)、空腹血糖(FBG)均使用美國(guó)貝克曼CX5 PRO全自動(dòng)生化分析儀測(cè)定,脂聯(lián)素測(cè)定采用放射免疫法,試劑購(gòu)于廣州標(biāo)佳科技有限公司,批內(nèi)CV<512%,批間CV<725%。
13統(tǒng)計(jì)學(xué)方法:采用EXCEL2003統(tǒng)計(jì)數(shù)據(jù),計(jì)量資料用(x±s)表示。兩組間比較采用t檢驗(yàn),各組間比較采用方差分析。Hs-CRP為非正態(tài)分布,以中位數(shù)和四分位間距表示,轉(zhuǎn)換為自然對(duì)數(shù)后呈正態(tài)分布。Hs-CRP、脂聯(lián)素與各指標(biāo)間的相關(guān)性采用簡(jiǎn)單相關(guān)分析,P<005有統(tǒng)計(jì)學(xué)意義。
2結(jié)果