2型糖尿病大血管病变与视黄醇结合蛋白4及高敏C反应蛋白关系的研究

目的 探讨2型糖尿病(T2DM)大血管病变患者血清视黄醇结合蛋白4(RBP4)及高敏C反应蛋白(hs-CRP)水平的变化.方法 入选研究对象115例,其中单纯T2DM组40例,T2DM大血管病变(病变T2DM)组40例,对照组35例.检测其空腹血清RBP4、hs-CRP,同时测空腹血糖(FBG)、身高、体重、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆同醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),计算体重指数(BMI)和稳态模型评估法胰岛素抵抗指数(HOMA-IR).分析三组RBP4水平的变化,及其与上述其他指标的相关性.结果 hs-CRP、RBP4在病变T2DM组和单纯T2DM组显著高于对照组[hs-CRP分别为(9.12±4.21)、(2.01±1.96)、(0.98±0.36)mg/L,RBP4分别为(30.10±5.45)、(20.02±5.32)、(12.02±3.45)mg/L](P<0.01),病变T2DM组显著高于单纯T2DM组(P<0.01).单因素相关分析显示RBP4与LDL-C、BMI、FBG、hs-CBP、FINS、HOMA-IR呈正相关(相关系数分别为0.325、0.597、0.323、0.571、0.275、0.463,P<0.05或<0.01).结论 血清RBP4、hs-CRP在糖尿病患者中显著升高,其水平变化与糖尿病大血管并发症的发生、发展密切相关.

Relationship between serum concentrations of retinol-binding protein 4 and high sensitive C reactive protein and macrovascular complications in type 2 diabetic mellitus patients

Objective To investigate the levels of serum retinol-binding protein 4 (RBP4) and high sensitive C reactive protein (hs-CRP) in type 2 diabetic mellitus (T2DM) patients with macrovascular complications. Methods All of 115 subjects were divided into 3 groups: normal control group (35subjects), T2DM patients with macrovascular complications group (40 subjects) and simple T2DM patients group (40 subjects). Serum RBP4 and hs-CRP was detected and fasting blood glucose(FBG), glycosylated hemoglobin A1c (HbA1c), triacylglycerol (TG), total cholesterol (TC), high density lipopretein cholesferel (HDL-C), low density lipoprotein cholesferol(LDL-C) and fasting insulin(FINS) were measured. Body mass index (BMI) and HOMA-IR was calculated. The correlation of RBP4 and other factors were analyzed.Results The concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group and simple T2DM patients group compared with those in normal control group [hs-CRP:(9.12±4.21),(2.01±1.96), (0.98±0.36)mg/L; RBP4:(30.70 ± 5.45), (20.02±5.32),(12.02±3.45)mg/L] (P<0.01). Also,the concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group compared with those in simple T2DM patients group (P<0.01). Univariate analysis showed that serum RBP4 was positively associated with LDL-C,BMI,FBG,hs-CRP,FINS,HOMA-IR (r=0.325, 0.597, 0.323, 0.571, 0.275, 0.463,P<0.05 or <0.01).Conclusions The concentrations of RBP4 and hs-CRP are significantly higher in T2DM patients. The changes of RBP4 and hs-CRP are closely related to the occurrence and development of diabetic macrovascular complications.