2型糖尿病伴血脂异常患者HDL-C与内皮依赖性血管舒张功能的关系

目的探讨2型糖尿病（T2DM）血脂异常患者HDL-C对血管并发症的保护作用。方法选择无血管并发症的T2DM并血脂异常患者48例,根据HDL-C水平将T2DM患者分为两组：正常HDL组（HDL-C≥1.04mmol/L）和低HDL组（HDL-C〈1.04mmol/L）。同期,选择26例健康个体作为对照。采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能（EDD）和硝酸甘油介导的内皮非依赖性血管舒张功能。结果（1）与对照组相比,正常HDL组和低HDL组BMI、FPG、2hPG、TC、TG、LDL-C明显高于对照组（P〈0.05～0.01）。低HDL组HDL-C明显低于对照组及正常HDL组（P〈0.01）,而正常HDL组HDL-C水平又低于对照组（P〈0.05）。（2）与对照组相比,正常HDL组和低HDL组EDD明显降低（P〈0.01）。与正常HDL组相比,低HDL组EDD明显降低（P〈0.01）。（3）多元线性相关分析表明,年龄、FPG、2hPG、LDL-C、HDL-C与EDD相关（P〈0.05）。结论在T2DM患者中,HDL-C对早期血管并发症具有保护作用。     

女性2型糖尿病患者载脂蛋白e4等位基因与内皮依赖性血管舒张功能降低有关

目的　探讨女性 2型糖尿病患者载脂蛋白e(Apoe)基因型与内皮依赖性动脉舒张功能的关系。方法　选择 101例无血管并发症女性 2型糖尿病患者和 95例年龄匹配的女性健康个体,采用PCR/ASO探针杂交技术检测其Apoe基因型,同时采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能和硝酸甘油(GNT)介导的内皮非依赖性血管舒张功能。结果　 (1)不论在女性 2型糖尿病患者还是在对照组,e4 /3、e4 /4基因型携带者内皮依赖性血管舒张功能〔分别为(3. 22±0. 29)%和(3. 78±0. 4)%〕,均低于此 2组的e2 /2、e3 /2携带者〔分别为(3. 96±0. 33)%和(4. 74±0. 41)%,P<0. 05〕。在各基因型间,基础血管内径、基础血流和GNT介导的血管舒张差异无统计学意义。(2)多元逐步回归分析结果显示,在女性 2型糖尿病患者中,年龄、血管内径、低密度脂蛋白胆固醇 (LDL C)、脂蛋白 (a)〔Lp(a)〕、Apoe4、空腹血糖、餐后 2h血糖、HbA1c、病程及阳性心血管病家族史与血流介导的内皮依赖性血管舒张功能均呈负相关(均P<0. 01);在对照组中,血流介导的内皮依赖性血管舒张功能与年龄、血管内径、LDL C、Lp(a)、Apoe4呈负相关(均P<0. 05)。结论　在无血管并发症女性 2型糖尿病患者和健康女性中,Apoe4等位基因与血流介导的内皮依赖     

Effect of insulin therapy on endothelium-dependent dilation in type 2 diabetes mellitus

Endothelial dysfunction is an early marker of atherosclerosis occurring in patients with type 2 diabetes mellitus. Endothelium-dependent dilation (EDD) has been shown to improve by combined therapy of insulin and metformin. Studies on endothelium-independent vasodilatory capacity, however, have had controversial results. We sought to investigate the vascular reactivity--EDD and endothelium-independent dilation--and their changes induced by the addition of insulin therapy to patients with type 2 diabetes mellitus pretreated with diet and oral hypoglycemic drugs. We therefore performed vascular studies in 21 poorly controlled type 2 diabetic patients and 11 nondiabetic control subjects by using high resolution ultrasound of the brachial artery. After 3 months of additional insulin therapy, vascular and laboratory measurements including C-reactive protein and parameters of glucose and lipoprotein metabolism were repeated. At baseline, EDD was significantly impaired in diabetic patients compared with controls (2.7 +/- 2.2% vs 7.0 +/- 1.8%, p <0.001), whereas endothelium-independent dilation was normal in both groups. After insulin therapy, EDD increased from 2.7 +/- 2.2% to 5.0 +/- 2.8% (p <0.001) in diabetic patients. All other vascular parameters did not change over the treatment period. The absolute change in EDD showed a significant negative correlation with the change in hemoglobin A(1c) (r = -0.67, p <0.001) and with fasting blood glucose (r = -0.84, p <0.001) levels. In contrast, there was no correlation between EDD and the observed changes in lipid and C-reactive protein levels. Our findings demonstrate that insulin therapy has beneficial effects on vascular function, resulting in enhanced EDD, most probably due to an improved glycemic control as the underlying mechanism.     

糖尿病及糖尿病合并下肢血管病变者血浆内皮微粒的变化

目的 研究正常人、糖尿病无大血管并发症(下称糖尿病,DM)、糖尿病合并下肢血管病变者(DL)循环内皮微粒(EMP)的水平,评价EMP做为内皮损伤的标志物可行性.方法 采用流式细胞术检测15例健康志愿者,15例单纯糖尿病患者和15例糖尿病合并下肢血管病变者血浆CD144阳性EMP水平.结果 糖尿病患者EMP水平较正常对照组升高[(418.59±102.65)个/μl、(617.13±147.19)个/μl,P<0.01],而糖尿病合并下肢血管病变者EMP水平又较糖尿病无并发症者升高[(617.13±147.19)个/μl、(1114.58±382.10)个/μl,P<0.05].结论 EMP可作为为评价糖尿病合并大血管病变的指标.     

Plasma endothelial microparticles and their correlation with the presence of hypertension and arterial stiffness in patients with type 2 diabetes

J Clin Hypertens (Greenwich). 2012; 14:455–460. ©2012 Wiley Periodicals, Inc. Microparticles (MPs) are associated with several cardiovascular complications. As multifunction biomarkers, they may contribute to the pathogenesis of diabetes‐associated vascular diseases. A total of 39 patients with diabetes and hypertension, 24 patients with diabetes without hypertension, and 20 healthy controls were enrolled. Flow cytometry was applied to detect plasma MPs, including endothelial MPs (EMPs), annexin V+MPs, platelet‐derived MPs (PMPs), and leukocyte‐derived MPs (LMPs). Brachial ankle pulse wave velocity (baPWV) was also performed in admission. Plasma EMPs, annexin V+MPs, PMPs, and LMPs in diabetics with or without hypertension were higher than those in control patients. Among diabetics, only EMPs in patients with hypertension was higher than in those without hypertension. Correlation analysis showed that systolic blood pressure and mean blood pressure were positively correlated with EMPs. Multivariant analysis demonstrated that EMP was an independent risk factor for the presence of hypertension in diabetics (odds ratio, 2.822; 95% confidence interval, 1.265–6.296; P=.011). Furthermore, baPWV in diabetics with hypertension (1910±355 cm/s) was higher than that in control patients (1441±198 cm/s) and diabetics without hypertension (1727±2 cm/s). Multivariant analysis identified EMP as a potent contributor to the development of impaired artery elasticity in diabetics (odds ratio, 4.401; 95% confidence interval, 1.529–12.673; P=.006). Plasma EMP was associated with the presence of hypertension and impaired arterial stiffness in type 2 diabetes.     

Treatment with rosiglitazone reduces hyperinsulinemia and improves arterial elasticity in patients with type 2 diabetes mellitus

OBJECTIVE: The aim of this study was to determine whether reduction of hyperinsulinemia with rosiglitazone will improve vascular elasticity in patients with non-insulin dependent diabetes mellitus. METHODS: In an open label study 52 patients with non-insulin dependent diabetes mellitus and at least one additional cardiovascular risk factor, were treated for 6 months with 4 mg of rosiglitazone, and uptitrated to 8 mg after 3 months of treatment, if needed. At the beginning of the study and at its end, blood was drawn for insulin, C- peptide, and 24-h urine collected for microalbuminuria/proteinuria. Glucose, chemistry, lipid profile, and hemoglobin A1C were determined at 0, 3, and 6 months. Vascular compliance was measured in monthly intervals. RESULTS: Treatment increased significantly small artery elasticity from 1.45 to 2.43 mL/mm Hg x 100. Large artery elasticity tended to increase toward the end of the study (P = not significant). Systolic blood pressure (BP)decreased from 144 to 124 mm Hg and diastolic BP decreased from 80 to 62.5 mm Hg, despite mild weight gain [corrected]. Heart rate tended to decrease from 76.3 to 74.7 beats/min (P = not significant). Systemic vascular resistance decreased from 1789.8 to 1329.4 dyne sec/cm(5). Plasma insulin, in patients not treated with insulin, decreased from 42.45 +/- 24.90 to 27.86 +/- 14.86 IU/mL (P =.0001). CONCLUSIONS: Treatment with rosiglitazone reduced hyperinsulinemia and improved small artery elasticity with a tendency to improve large artery elasticity, in hypertensive and in normotensive patients. Because rosiglitazone improves insulin receptor sensitivity (IRS), it is logical to assume that the reduction in hyperinsulinemia reflects improvement in IRS. Our data support the hypothesis that hyperinsulinemia and IRS participate in the mechanisms of tissue injury and their improvement induces improvement in arterial elasticity.     

Apolipoprotein e4 allele and endothelium-dependent arterial dilation in Type 2 diabetes mellitus without angiopathy

AIMS/HYPOTHESIS: Several studies have suggested a predisposing role of the e4 allele of apolipoprotein E (ApoE) in the development of atherosclerosis and cardiovascular disease in Type 2 diabetes. Therefore, we hypothesized that the e4 allele is also a risk factor for endothelial dysfunction. We attempted to assess whether Apo e4 allele is associated with endothelial dysfunction in the early stage of Type 2 diabetes. METHODS: We selected 255 Chinese Han Type 2 diabtetic men without angiopathy. PCR or allele-specific oligonucleotide probes were used to analyse ApoE genotypes, and high resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperaemia and after sublingual glyceryltrinitrate. RESULTS: The flow-mediated arterial dilation among the subjects with e4/3 or e4/4 was 3.14+/-0.32%, which was lower than that in subjects with e2/2 or e3/2 (4.04+/-0.30%) ( p=0.038). The baseline vessel size, glyceryltrinitrate-induced arterial dilation and baseline flow were not different among different ApoE genotypes. On univariate analysis, reduced flow-mediated arterial dilation was related to total cholesterol, LDL, lipoprotein(a) [Lp(a)], high blood pressure, older age, family history of premature vascular disease, larger vessel size, cigarette smoking, duration of diabetes and e4 allele ( p<0.05). By multiple stepwise regression analysis, reduced flow-mediated arterial dilation was associated with cigarette smoking, LDL, Lp(a), and e4 allele ( p<0.01). CONCLUSION/INTERPRETATION: Apo e4 allele is associated with impairment of endothelium-dependent arterial dilation in the early stage of Type 2 diabetes.     

Apo e4 allele is associated with endothelium-dependent arterial dilation in women with type 2 diabetes

OBJECTIVE: Previous studies have suggested that the e4 allele of apolipoprotein E (apo E) relates to the endothelium-dependent arterial dilation in men with type 2 diabetes. This study attempted to assess whether apo e4 allele is associated with endothelial dysfunction in women with type 2 diabetes. RESEARCH DESIGN AND METHODS: We selected 144 Chinese Han female type 2 diabetic patients without clinically detectable angiopathy. Polymerase chain reaction/ASO probes were used to determine their mouthwash DNA apo E genotypes, and high-resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperemia (with increased flow causing endothelium-dependent dilation) and after sublingual glyceryltrinitrate (GTN, an endothelium-independent dilator). RESULTS: The flow-mediated arterial dilation among the subjects with e4/3 or e4/4 was 3.56+/-0.23%, which was significantly lower than that in subjects with e2/2 or e3/2 (3.97+/-0.36%) (p=0.000). The baseline vessel size, GTN-induced dilation and baseline blood flows were not significantly different among different apo E genotypes. On univariate analysis, reduced flow-mediated arterial dilation was significantly related to total cholesterol, LDL, Lp(a), high blood pressure, older age, family history of premature vascular disease, larger vessel size, duration of diabetes and e4 allele (p<0.05). By multiple stepwise regression analysis, reduced flow-mediated arterial dilation was associated with older age, large vessel size, duration of diabetes, positive family history, LDL, Lp(a) and e4 allele (p<0.01). CONCLUSION: The apo e4 allele is associated with impairment of endothelium-dependent arterial dilation in the relatively early stage of female type 2 diabetes.     

2型糖尿病患者护骨素与内皮依赖性血管舒张功能的关系

目的 探讨2型糖尿病患者护骨素与内皮依赖性血管舒张功能（EDAD）的关系。方法 选择40例新诊断的2型糖尿病患者和46名健康个体。2型糖尿病患者采用胰岛素治疗6个月。血浆护骨素采用ELISA法测定。采用高分辨血管外超声法检测肱动脉血流介导的EDAD和硝酸甘油介导的内皮非依赖性血管舒张功能。结果 2型糖尿病患者治疗前血浆护骨素为（3．44±0．52）ng／L，明显高于对照组（2．38±0．25）ng／L（P〈0．01），治疗6个月后血浆护骨素水平明显降低（2．61±0．55）ng／L（P〈0．01）。2型糖尿病患者治疗前EDAD为（3．19±0．52）％，明显低于对照组的（4．46±0．56）％（P〈0．01），治疗6个月后明显改善（4．18±0．48）％（P〈0．01）。多元相关分析显示，治疗前血浆护骨素与EDAD、空腹血糖（FPG）、HbA1C超敏C反应蛋白（CRP）相关（均P〈0．01）。治疗前后护骨素的变化与EDAD、FPG、HbA1C、CRP的变化相关（P〈0．01）。结论 新诊断的2型糖尿病患者血浆护骨素水平明显增高，血浆护骨素与血管内皮功能相关。     

Circulating homocysteine levels in patients with type 2 diabetes mellitus

Background and aimPrevious studies have shown conflicting results regarding circulating homocysteine levels in patients with type 2 diabetes.Methods and resultsThis observational study included 2121 patients with angiographically proven coronary artery disease (507 patients with type 2 diabetes and 1614 patients without diabetes). Circulating homocysteine levels, methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism, renal function, presence of coronary artery disease (CAD) diagnosed by coronary angiography, and circulating folate and vitamin B₁₂ status were assessed. Plasma homocysteine levels [median (25th; 75th percentile)] were significantly higher in patients with diabetes than in those without [12.4 μmol/L (9.9 μmol/L; 15.9 μmol/L) versus 11.7 μmol/L (9.6 μmol/L; 14.5 μmol/L), P = 0.011]. Diabetes affected homocysteine levels only in patients with a glomerular filtration rate <90 mL/min [13.0 μmol/L (10.5 μmol/L; 16.7 μmol/L) in patients with diabetes versus 12.2 μmol/L (10.1 μmol/L; 15.2 μmol/L) in patients without diabetes, P = 0.006] but not in those with a glomerular filtration rate ≥90 mL/min [10.1 μmol/L (8.1 μmol/L; 12.4 μmol/L) versus 10.2 μmol/L (8.8 μmol/L; 12.3 μmol/L), P = 0.267]. Multivariable analysis did not show an independent association between diabetes and homocysteine level (P = 0.342).ConclusionCirculating homocysteine levels are increased in patients with type 2 diabetes compared with non-diabetic patients due to a more diabetes-associated adverse risk profile rather than to diabetes itself.     

2型糖尿病病人血管内皮依赖性舒张功能的改变

目的　了解 2型糖尿病病人血管内皮依赖性舒张功能的改变。方法　分别选取对照组、2型糖尿病组及 2型糖尿病合并血脂异常组 ,采用高分辨血管外超声法检测其肱动脉血流介导的内皮依赖性舒张功能和硝酸甘油介导的内皮非依赖性舒张功能。同时测定血脂水平。结果　 12型糖尿病组和 2型糖尿病合并血脂异常组内皮依赖性舒张功能较对照组均明显降低 ( P <0 .0 5) ;2型糖尿病合并血脂异常组较 2型糖尿病组有减退 ,但无显著差异 ( P>0 .0 5)。 2 2型糖尿病合并血脂异常组非内皮依赖性舒张功能较 2型糖尿病组及对照组减退 ,差异显著 ( P<0 .0 5) ;2型糖尿病组与对照组无显著性差异 ( P>0 .0 5)。结论　 2型糖尿病对血管内皮功能有影响 ,且影响因素是多方面的 ,既有糖代谢紊乱因素 ,又有脂代谢紊乱因素     

急性高血糖对2型糖尿病患者一级亲属血管内皮功能的抑制作用

目的 探讨急性高血糖对2型糖尿病(T2DM)患者一级亲属血流中介内皮依赖性血管舒张功能(FMD)的影响.方法 选择32例正常葡萄糖耐量个体,其中,父母均为糖尿病患者的17例[家族史阳性组(FH+组)];一级亲属无DM及冠心病者15例[家庭史阴性组(FH-组)].采用高分辨血管外超声测定空腹状态、口服75g葡萄糖后1～2h FMD.结果 与FH-组相比,FH+组空腹状态及服糖后1～2h FMD明显降低.在FH+组,与0h相比,1h FMD明显降低;与1h相比,2h FMD明显增高,但仍明显低于空腹状态.回归分析显示,FMD与FH+相关.FH+组FMD与血糖、硫巴比妥酸反应物相关(P<0.05或P<0.01).结论 FH+个体存在血管内皮功能异常;急性高血糖快速降低其FMD.因此,推测T2DM家族史可作为额外的心血管病危险因子.     

Meal intake increases circulating procoagulant microparticles in patients with type 1 and type 2 diabetes mellitus

Diabetes mellitus (DM) is associated with prothrombotic alterations, and postprandial hyperglycemia is an independent risk factor for cardiovascular complications. We therefore investigated whether a standardized mixed meal alters circulating microparticles (MPs) and their procoagulant activity in DM patients.

Patients with DM type 1 (T1DM, n = 11) and type 2 (T2DM; n = 9) were studied before and 90 min after a standardized meal (without premeal insulin). MPs in plasma derived from platelets (PMPs), endothelial cells (EMPs), or monocytes (MMPs) were measured by flow cytometry. MP-induced thrombin generation in plasma was assessed by a calibrated automated thrombogram.

In the fasting state, MPs did not differ significantly between T1DM and T2DM. Meal intake increased the following microparticles: PMPs expressing phosphatidylserine (by 55%, on average), P-selectin (by 86%), and tissue factor (TF; by 112%); EMPs expressing E-selectin (by 96%) and MMPs expressing TF (by 164%), with no significant group differences between T1DM and T2DM. There were no increments in EMPs expressing phosphatidylserine or TF. Meal intake increased MP-induced thrombin generation similarly in T1DM and T2DM with increased endogenous thrombin potential (p = 0.02) and peak thrombin (p = 0.03) and shortened time to peak (p = 0.02). Phosphatidylserine inhibition by lactadherin completely abolished MP-induced thrombin generation, while an anti-TF antibody had no effect.

In conclusion, meal intake increased several types of circulating MPs in patients with diabetes mellitus. These MPs have a procoagulant potential, which is related to phosphatidylserine expression and negatively charged MP surfaces rather than to TF.     

eNOS基因5''''-侧翼区T-786→C突变与2型糖尿病患者内皮依赖性血管舒张功能的关系

目的 探讨2型糖尿病(T2DM)患者内皮一氧化氮合酶(eNOS)基因5'-侧翼区T-786→C突变与T2DM患者内皮依赖性血管舒张功能(EDD)关系.方法 选择无血管并发症的男性T2DM患者162例.采用PCR/ASO探针杂交技术检测eNOS基因5'-侧翼区T-786→C突变.采用高分辨超声检测肱动脉血流介导的EDD.结果 T/C或C/C组EDD为3.73%±0.50%,明显低于T/T组(4.15%±0.49%)(P＜0.01).多元逐步分析结果显示,在所有T2DM患者中,EDD与C等位基因呈负相关(P=0.001).在吸烟者中,T/C或C/C组EDD明显低于T/T组(P＜0.05),在非吸烟者中则不然.多元逐步分析结果显示,在吸烟者中,C等位基因是EDD下降的独立危险因子(P＜0.01),在非吸烟者中则不然.结论 eNOS基因5'-侧翼区T-786→C突变是T2DM患者内皮功能异常的遗传危险因子,尤其是吸烟的T2DM患者.     

1型糖尿病患者胰岛素治疗前后内皮依赖性血管舒张功能的变化

选择18例1型糖尿病（TIDM）患者和20例健康人。TIDM采用胰岛素治疗。治疗前TIDM血流介导的内皮依赖性血管舒张功能为3．97％，明显低于治疗后的4．60％和对照组的4．87％（P〈0．05）。治疗前后血流介导的内皮依赖性血管舒张功能变化与FPG、2hPG、TG、HbA;c变化呈负相关（P〈0．05）。     

The correlation of common carotid arterial diameter with atherosclerosis and diabetic retinopathy in patients with type 2 diabetes mellitus

The clinical significance of the diameter of the common carotid artery (CCA) measured ultrasonographically in diabetic practice has not been sufficiently established. The objective of this study was to investigate the relationship of the ultrasonic CCA diameter with atherosclerotic measures and diabetic retinopathy as a microvascular complication in patients with type 2 diabetes mellitus (T2DM). This hospital-based cross-sectional study included 102 patients with T2DM (men: 65%, mean age: 57 years) who had no apparent carotid arterial stenosis and no history of cardiovascular or severe renal disease. The current smoking status, body mass index, blood pressure, hemoglobin A1c, serum low-density lipoprotein cholesterol, and ultrasonic measures of carotid arteries (CCA diameter, intima-media thickness (IMT), plaque score) were measured. The cardio-ankle vascular index (CAVI) and the presence of diabetic retinopathy were also assessed. The CCA diameter showed a significant positive correlation with the mean IMT or plaque score. The CAVI had a significant positive correlation with the mean IMT, plaque score, and CCA diameter, while diabetic retinopathy had a significant positive correlation with the CCA diameter, but not the mean IMT or plaque score. These results were unaltered after adjusting for multiple confounders. The CCA diameter may serve as a useful marker for atherosclerosis and diabetic retinopathy, and in particular, may be a marker associated with diabetic retinopathy more clearly than the carotid IMT and plaque score, in patients with T2DM.     

血清内脏脂肪素水平在2型糖尿病患者中升高

目的探讨内脏脂肪素（visfatin）与2型糖尿病（T2DM）的关系。方法采用酶联免疫吸附试验（ELISA）测定56例T2DM患者和58例健康对照（NC）的血清visfatin水平，同时测定血压、血脂、视黄醇结合蛋白（RBP-4）、FPG、Fins水平，计算腰臀比（WHR）、BMI、胰岛素抵抗指数（HOMA-IR），并且分析以上各指标与visfatin的关系。结果Visfatin水平在T2DM组显著高于NC组（P〈0.01），其水平与WHR具有显著相关性（P〈0．05），与BMI在T2DM组具有显著相关性，而在NC组没有显著相关性（P〉0.05）；与血压、血脂、空腹血糖和空腹胰岛素水平没有显著的相关性。RBP-4的表达在两组间差异无统计学意义（P〉0.05）。结论Visfatin的表达可能在T2DM的发生和发展中具有一定的作用。     

Postprandial lipaemia suppresses endothelium-dependent arterial dilation in patients with hypothyroidism

Endothelial dysfunction represents an early step in the development of atherosclerosis. The purpose of this study was to investigate the relationship between postprandial lipaemia and endothelial dysfunction in patients with overt hypothyroidism (oHT) and subclinical hypothyroidism (sHT). Female subjects with oHT and sHT, as well as female healthy subjects with euthyroid state were enrolled (10 cases in each group). The examination of flow-mediated dilation (FMD) was performed before and after an oral fat-loading by high resolution ultrasound. Endothelial dysfunction after an oral fat challenge was related to the extent of hypertriglyceridemia and free radicals. FMD decreased significantly at 4-h point in 3 groups, (p?相似文献   

老年糖尿病患者血清脂联素与炎症因子的相关性研究

目的检测老年糖尿病患者血清脂联素与炎症因子水平,并探讨二者的相关性。方法测定老年健康人(对照组)、老年2型糖尿病无大血管并发症患者(无血管病变组)及2型糖尿病伴大血管并发症患者(血管病变组)的血清脂联素与炎症因子C反应蛋白、肿瘤坏死因子(TNF-α)水平。结果血清脂联素水平,对照组、无血管病变组及血管病变组分别为(10．67±3．26)mg/L、(6．43±2．64)mg/L和(4．31±2．17)mg/L,组间比较差异有统计学意义(均为P＜0．01);3组血浆C反应蛋白水平分别为(1．64±0．37)mg/L、(4．86±1．82)mg/L和(6．62±1．91)mg/L,TNF-α分别为(5．83±1．37)pg/L、(8．94±3．28)pg/L和(15．31±3．65)pg/L,依次逐渐升高,组间比较差异有统计学意义(均为P＜0．01)。无血管病变组和血管病变组脂联素与C反应蛋白、TNF-α、腰围、体质指数、腰臀比值及空腹血糖、餐后2 h血糖、糖化血红蛋白、三酰甘油均呈显著负相关。多元逐步回归分析显示,脂联素与C反应蛋白(r~2=0．18)、TNF-α(r~2=0．25)、腰臀比(r~2=0．21)及糖化血红蛋白(r~2= 0．19)具有相关性(均为P＜0．05)。结论脂联素可能是老年人糖尿病发生、发展及糖尿病大血管病变形成中炎症反应的保护因素。