2型糖尿病患者血浆PAI-1水平与尿微量白蛋白的相关性研究

目的探讨2型糖尿病(T2DM)患者血浆PAI-1水平变化及其与尿微量白蛋白(MAU)的相关性,了解PAI-1在2型糖尿病及其血管并发症发病机制中的作用。方法选取60例未经过治疗的初诊T2DM患者(观察组)和30例与T2DM患者临床资料相匹配的正常健康体检者(对照组)为研究对象,并根据MAU检测结果将观察组分为MAU正常亚组(30例)和MAU阳性亚组(30例),按标准方法检测研究对象的血糖(FBG)、胰岛素(FINS)、糖化血红蛋白(HbA1c)、血脂(TC、TG、LDL-C和HDL-C)、血浆PAI-1、MAU等,并应用SPSS11.0统计软件对检测结果进行相应的统计学分析。结果 (1)观察组FBG、HbA1c、TC、TG、LDL-C水平显著高于对照组(P<0.01或P<0.05),但两组HDL-C水平无显著差异(P>0.05),而且观察组两亚组间各指标差异均无统计学意义(P>0.05)。(2)MAU正常亚组FINS水平与对照组差异无统计学意义(P>0.05),但MAU阳性亚组FINS水平显著高于对照组(P<0.05),且观察组两亚组间差异无统计学意义(P>0.05)。(3)观察组HOMA-IR水平显著高于对照组(P<0.05),但观察组两亚组之间差异无统计学意义(P>0.05)。(4)观察组两个亚组血浆PAI-1水平均显著高于对照组(P<0.01),而且MAU阳性亚组血浆PAI-1水平亦显著高于MAU正常亚组(P<0.01)。(5)血浆PAI-1水平与Alb/cr、HOMA-IR、FBG、HbA1c、BMI、TC、TG等指标水平均呈正直线相关(P<0.01或P<0.05);多元逐步回归分析显示Alb/cr、HbA1c水平为影响空腹血浆PAI-1水平的显著因素,其中HbA1c可以解释空腹血浆PAI-1浓度变化的49.3%、Alb/cr可以解释空腹血浆PAI-1浓度变化的28.9%(校正的R2值分别为0.493、0.782,P均<0.01)。结论 (1)T2DM患者血浆PAI-1水平升高,而且伴有MAU阳性的患者血浆PAI-1水平升高更为明显。(2)血浆PAI-1水平与MAU水平呈正直线相关,表明PAI-1可能是糖尿病血管并发症发生的一个危险因素。

Relations of the level of plasma PAI-1 with urine micro-albumin in type 2 diabetes mellitus

Objective To evaluate the relevance of plasma PAI-1 levels and MAU in patients with type 2 diabetes mellitus,to understand the role of PAI-1 in in the pathogenesis of type 2 diabetes mellitus and its vascular complications.Methods Selected 60 cases of newly diagnosed T2DM patients without treatment(experimental group)and 30 health cases(control group)as the research object,according to the results of MAU the(experimental group were divided into MAU normal group(n=30)and MAU positive group(30 cases),detection the result of FBG,FINS,HbA1c,blood lipid(TC,TG,LDL-C and HDL-C),plasma PAI-1,MAU et,make the corresponding statistical analysis.With the SPSS11.0 to test results.Results(1)The experimental group FBG,HbA1c,TC,TG,LDL-C was significantly higher than that of control group(P<0.01 or P<0.05),but the HDL-C level had no significant difference(P>0.05),and between the subsets of experiment there was no statistically significant difference(P>0.05).(2)Comparing FINS between control group and MAU normal group,there was no significant difference(P>0.05),but MAU positive group were significantly higher than that of control group(P<0.05),between the various sub-groups in experiment group there was no statistical significant difference(P>0.05).(3)The HOMA-IR levels of the experimental group were higher than those in control group(P>0.05),between the subsets of experiment there was no statistically significant difference(P>0.05).(4)The level of plasma PAI-1 of Experimental group was higher than the control group(P<0.01),MAU positive group was higher than the MAU normal group(P<0.01).(5)The result of PAI-1 were linear correlation with the result of Alb/Cr,HOMA-IR,FBG,HbA1c,BMI,TC,TG(P<0.01 or P<0.05);Multiple stepwise regression analysis showed that Alb/Cr,HbA1c levels were significant factors that affect the fasting plasma PAI-1 levels,which could explain HbA1c fasting plasma PAI-1 concentration of 49.3%,Alb/cr could explain the changes in fasting plasma concentrations of PAI-1 28.9%(corrected R2 values were 0.493、0.782,P<0.01)Conclusion(1)Plasma PAI-1concentration in patients with type 2diabetes mellitus increases,and it increased greater in those patients type 2 diabetes mellitus with microalbuminuria.(2)Plasma PAI-1 and urine microalbumin in patients with type 2 diabetes mellitus had a positive correlation.It showed that PAI-1 may be one of the factors that occurred the vascular complications.