血清脂联素、同型半胱氨酸、超敏C反应蛋白、胰岛素抵抗与2型糖尿病大血管病变关系的研究

[目的]探讨血清脂联素(APN)、同型半胱氨酸(tHcy)、超敏C反应蛋白(hsCRP)、稳态模型评估的胰岛素抵抗指数(Homa-IR)与2型糖尿病(T2DM)大血管病变的关系.[方法]将受试者分为对照组、T2DM无血管病变组(DM1组,n=45)和大血管病变组(DM2,n=65).测定血清APN、t-Hcy、hsCRP及相关指标,计算Homa IR.[结果]①单因素方差分析显示,DM2组病程、腰围(WC)、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1C)、Homa-IR、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、tHcy、hs-CRP等指标均显著高于DM1和对照组,而APN却显著低于其他两组(P＜0.05).②多元逐步回归分析表明WC(R2 =-0.37)、HOMA-IR(R2=-0.49)、hs-CRP(R2=-0.37)、tHcy(R2=-0.21)是影响APN的重要因素(P＜0.05).③Logistic回归分析显示血清APN、tHcy、hsCRP和HOMA-IR水平增高是糖尿病大血管病变的独立的危险因素.[结论]APN、tHcy、hsCRP、HOMA-IR参与了糖尿病大血管并发症的发生.APN可能通过减少炎症因子表达,减轻胰岛素抵抗,从而防治糖尿病大血管并发症的发生.

Study on Correlation of Serum Adiponectin, Homocysteine, High Sensitive C Reactive Proteinand Insulin Resistance with Macroangiopathy in Type 2 Diabetes Mellitus

[Objective]To explore the correlation of serum adiponectin（APN）, homocysteine（tHcy）, high sensitive C reactive protein（hs-CRP）, homeostasis model assessment of insulin resistance index（HOMA-IR） with macroangiopathy in type 2 diabetes mellitus（T2DM）. [Methods] All subjects were divided into control group, T2DM without macroangiopathy group（DM1 group） and T2DM with macroangiopathy group（DM2 group）. Serum APN, tHcy, hs-CRP and other factors were measured. HOMA-IR was calculated. [Results] Univariate ANOVA showed that disease course, waist circumference（WC）, FPG, 2hPG, HbA1C, HOMA- IR, TG, LDL-C, Hcy and hs-CRP in DM2 group were significantly higher than those in DM1 group and con- trol group, while APN in DM2 group was significantly lower than that in other two groups（ P d0.05） . Mul- tiple stepwise regression analysis showed that WC（R2 = --0.37）, HOMA-IR（R2 =--0.49）, hs-CRP（Rz = -- 0.37） and tHcy（R2 = --0.21） were the important factors affecting the level of APN（ P d0.05）. Logistic re- gression analysis showed that the increasing of serum APN, tHcy, hs-CRP and HOMA-IR were the independ- ent risk factors of macroangiopathy in T2DM. [Conclusion] APN, t-Hcy, hs-CRP and HOMA-IR participate in the pathogenesis of diabetic macrovascular complications. APN may prevent the incidence of macrovascular complications in T2DM through reducing the inflammatory factors and decreasing IR.