不同糖代谢状态患者血清p选择素和sCD40L水平变化及意义

目的探讨不同糖代谢状态与血小板活化指标—可溶性p选择素(sP-selectin)、可溶性CD40L(sCD40L)的关系,并进一步研究其影响因素。方法分别选取正常对照组(NC组)、糖尿病前期组和2型糖尿病组(T2DM组)患者各30例,计算体质量指数(BMI),采集空腹静脉血测定血糖(FPG)、胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、糖化血红蛋白(HbA1C)等指标,酶联免疫法(ELISA)测定静脉血清中sP-selectin、sCD40L水平,计算稳态模型胰岛素抵抗评估指数(HOMA-IR)。结果糖尿病前期组和T2DM组的sP-selectin和sCD40L较NC组明显升高(P<0.05)。sP-selectin的表达与FPG、TG、TC、LDL-C、HOMA-IR呈正相关,与HDL-C呈负相关(P均<0.05),其中与TG和FPG的相关性更高(P<0.01);sCD40L与FPG、BMI、HbA1c呈正相关(P均<0.05),与TG、TC、HOMA-IR无明显相关性(P均>0.05)。结论糖尿病前期及T2DM人群血清中sCD40L和sP-selectin水平已明显升高,提示血小板活化在糖尿病前期已启动。

Change of soluble P-selectin and soluble CD40L levels in patients with different glucose metabolisms

Objective To investigate the levels of platelet activation indexes including soluble P-selectin(sP-selectin) and soluble CD40L(sCD40L) in subjects with different glucose metabolisms,and analyze the influencing factors for further study.Methods The study enrolled pre-diabetic,T2DM patients and normal controls(NC) with 30 subjects in each group.Body mass index(BMI) was calculated.Fasting plasma glucose(FPG),insulin(FINS),triglyceride(TG),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),high-density lipoprotein-cholesterol(HDL-C) and glycated hemoglobin(HbA1C) levels were measured.Soluble P-selectin and soluble CD40L in serum were measured by enzyme-linked immunosorbent assay.Moreover,HOMA-IR of insulin resistance was calculated by homeostasis models.Results The sCD40L and sP-selectin levels in pre-diabetes and T2DM groups were significant higher compared with those of the NC group(P<0.05).The sP-selectin level was positively correlated with FPG,TG,TC,LDL-C and HOMA-IR(P<0.05),in addition,its correlation with TG and FPG was especially higher(P< 0.01).But it was negatively correlated with HDL-C(P<0.05).Furthermore,the sCD40L level was positively correlated with FPG,BMI,and HbA1c(P<0.05).However,it was not associated with TG,TC and HOMA-IR(P>0.05).Conclusions The sCD40L and sP-selectin levels significantly increase in pre-diabetic and diabetic subjects,which suggests platelet activation has occurred during the pre-diabetic stage.