血浆护骨素水平与内皮祖细胞在老年2型糖尿病患者血管病变中的关系探讨

目的 探讨老年2型糖尿病（T2DM）患者血浆护骨素（OPG）水平与外周血内皮祖细胞（endothelial progenitor cells,EPCs）含量的相关性,并分析在老年T2DM血管病变中的作用.方法 （1）采用流式细胞仪测定20例初诊T2DM患者、20例血糖控制良好（HbA1c ＜7％） T2DM患者（A组）、20例血糖控制中等（HbA1c7％～11％） T2DM患者（B组）、20例血糖控制较差（HbA1c＞1 1％） T2DM患者（C组）及10例糖耐量正常的健康对照者外周血中EPCs的含量; （2）采用酶联免疫分析法检测上述患者的血浆OPG水平.结果 （1）EPCs在T2DM组低于健康对照组,OPG在T2DM组高于健康对照组,且均有统计学差异（P＜0.05）; （2）C组血浆EPCs的水平低于B组及A组,B组低于A组,且有统计学差异（P＜0.05）;C组血浆OPG的水平高于B组及A组（P＜0.01）,B组血浆OPG的水平高于A组,差异有统计学意义（P＜0.05）; （3）单因素分析结果显示,糖尿病患者外周血中OPG水平与EPCs含量呈负相关（r=-0.354,P＜0.05）;多元回归分析结果显示,FPG、OPG、EPCs为血管病变的影响因素（P＜0.05）.结论 老年T2DM患者中空腹血清OPG水平与EPCs存在一定关系,二者可能在老年T2DM血管病变发生发展中发挥一定作用.

The Relationship of Plasma Osteoprotegerin Level and Endothelial Progenitor Cells in Vascular Lesions of Patients with Type 2 Diabetes Mellitus

Objective To study the relationship between endothelial progenitor cells （EPCs） and plasma osteoprotegerin （OPG） level,and explore the role of vascular lesions in type 2 diabetes mellitus （T2DM）Methods 20 cases of untreated T2DM patients,20 cases of well-controlled T2DM （group A,HbA1c ＜ 7％）,20 cases of middle-controlled T2DM （group B,HbAlc 7-11％）,and 20 cases of bad-controlled T2DM （group C,HbA1c ＞ 11％） were treated by oral anti-diabetic drugs,while 10 normal glucose tolerance subjects were involved as control.EPCs was measured by FCM and plasma OPG level was determined using ELISA.Results （1）EPCs in untreated T2DM group was lower,while OPG was higher compared to healthy control group （P ＜ 0.05）.（2） There were significant differences in EPCs among groups A,B and C （P＜ 0.05）.The better the control was,the lower of EPCs was.The OPG level in group C was higher than that in groups A and B （P ＜ 0.01）,and in group B was higher than that in group A （P ＜ 0.05）.（3） The results of univariate analysis showed that OPG level was negatively correlated with EPCs （r =-0.354,P ＜ 0.05）.And the results of multiple factor analysis suggested that FPG,OPG and EPCs were the critical influence factors of vascular lesions in elderly T2DM.Conclusion In elderly patients with T2DM,OPG level in fasting serum has a certain negative relationship with EPCs,and OPG and EPCs might have some roles in vascular lesions in elderly T2DM.