初诊2型糖尿病患者踝肱指数异常率及相关因素分析

目的了解初诊2型糖尿病患者踝肱指数异常率及其影响因素。方法采用多普勒血流探测仪测定85例初诊2型糖尿病患者踝肱指数（ABI）并进行分组,ABI〈0.9为糖尿病下肢血管病变组（低ABI组）,0.9≤ABI〈1.3为非糖尿病下肢血管病变组（正常组）,ABI≥1.3为下肢动脉硬化组（高ABI组）,记录各组患者年龄、性别体重指数、血压、吸烟史等一般情况,并检测糖脂等代谢指标,通过回归分析探讨影响ABI的危险因素。结果初诊2型糖尿病患者的异常ABI为21.2%,与正常组比较,低ABI组和高ABI组年龄、吸烟率、HbA1c、TG、收缩压、UA均明显升高,其糖尿病视网膜病变、糖尿病肾病、糖尿病周围神经病变发生率亦明显升高。结论初诊糖尿病患者有较高的外周动脉病变（PAD）患病率;高龄、高血压、长期血糖控制不佳、脂质代谢紊乱是糖尿病下肢血管病变的危险因素。     

糖代谢异常者臂-踝脉搏波传导速度与颈动脉内膜中层厚度的变化

目的 研究糖调节功能正常、糖调节功能减低和糖尿病患者中,颈动脉内膜中层厚度(IMT)及臂-踝脉搏波传导速度(baPWV)的变化,探讨其与糖尿病早期动脉粥样硬化的关系.方法 收集糖尿病患者42例、糖调节功能减低者45例、正常对照者30例的临床资料,每例均采用全自动动脉硬化仪测定baPWV及超声检测IMT,将三组的数据进行比较分析.结果 从正常对照者、糖调节功能减低者至糖尿病患者,随着糖代谢异常程度的加重,颈动脉内膜中层逐渐增厚(P＜0.05),baPWV逐渐升高(P＜0.05).结论 在糖代谢异常的早期baPWV与IMT即发生明显改变,二者对筛查糖尿病动脉粥样硬化并发症有一定的价值.     

踝肱和趾肱指数在预测2型糖尿病微血管并发症与大血管并发症发生风险中的价值对比

目的 对比分析踝肱和趾肱指数在预测2型糖尿病微血管并发症与大血管并发症发生风险中的价值.方法 收集比较受试对象既往踝肱和趾肱指数水平及相关影响因素并进行讨论和分析,应用SPSS 20.0统计软件分析.结果 不同性别、不同血糖控制水平患者间ABI与TBI分布特征的比较提示,无论男女均可见单纯糖尿病组患者ABI和TBI异常比例最低.血糖控制优良的患者中,三组患者ABI和TBI异常的比例均显示微血管病变和大血管病变患者比例高于单纯糖尿病组患者,P<0.05;在血糖控制不佳的患者中也见到类似趋势;三组患者血糖控制不佳者ABI和TBI异常的比例均分别高于血糖控制良好者,P<0.05;回归分析提示ABI和TBI异常均为三种并发状态发生的危险因素,均有P<0.05;调整了性别年龄、血糖控制水平后仍均表现为危险因素,P<0.05.结论 ABI与TBI的异常可以作为预测2型糖尿病患者微血管以及大血管病变的预测因子在临床中起到重要作用.     

Atrial fibrillation risk factors in patients with ischemic stroke

IntroductionAtrial fibrillation (AF) is the most common heart arrhythmia. The condition is known to increase the risk of ischemic stroke (IS). Classical risk factors for the development of AF include advanced age, hypertension, diabetes mellitus, coronary heart disease and lipid metabolism disorders. Importantly, these are also recognized risk factors for ischemic stroke. Therefore, the purpose of this study was to investigate AF risk factors in patients with IS.Material and methodsThis is single-centre retrospective study which included 696 patients with acute ischemic stroke and nonvalvular atrial fibrillation and 1678 patients with acute ischemic stroke without atrial fibrillation.ResultsIn this study we found – based on a univariable and multivariable logistic regression model – that compared to the patients with IS without AF, the group of patients which suffered from IS with nonvalvular atrial fibrillation (NVAF) had a higher proportion of patients who smoked cigarettes (OR = 15.742, p < 0.01; OR = 41.1, p < 0.01), had hypertension (OR = 5.161, p < 0.01; OR = 5.666, p < 0.01), history of previous stroke (OR = 3.951, p < 0.01; OR = 4.792, p < 0.01), dyslipidemia (OR = 2.312, p < 0.01; OR = 1.592, p < 0.01), coronary heart disease (OR = 2.306, p < 0.01; OR = 1.988, p < 0.01), a greater proportion of female patients (OR = 1.717, p < 0.01; OR = 2.095, p < 0.01), higher incidence of diabetes mellitus (OR = 1.341, p < 0.01; OR = 1.261, p = 0.106) and more patients in old age (OR = 1.084, p < 0.01; OR = 1.101, p < 0.01).ConclusionsOur study demonstrates a need for thorough and systematic monitoring of post-ischemic stroke patients in whom AF has not been detected and who display other important risk factors. Regardless of the stroke, these factors may be responsible for development of AF.     

对氧磷酶2基因C311S多态性与2型糖尿病合并缺血性脑卒中的相关性

目的 探讨对氧磷酶2(paraoxonase 2，PON2)基因多态性与2型糖尿病(type 2 diabetes mellitus，T2DM)患者合并缺血性脑卒中(ischemic stroke，IS)的关系。方法 用聚合酶链反应—限制性片段长度多态性分析法探查PON2基因C311S多态性在T2DM合并IS组、T2DM无IS组以及正常对照组的基因频率。结果 发现中国人存在PON2基因C311S多态性，C／S等位基因频率为0．145／0．855。T2DM合并IS组患者PON2基因的C等位基因频率显著高于T2DM无IS组和正常对照组，差异有显著性(P＜0．05)。结论 中国人2型糖尿病患者PON2基因第311位密码子的多态性与并发缺血性脑卒中有关，C等位基因是2型糖尿病并发缺血性脑卒中的危险因素之一。     

Vital exhaustion as a risk indicator for first stroke

Fatigue is a common condition after stroke. An unresolved question is whether the fatigue is a consequence of the stroke or is one of the precursors. The authors' objective was to investigate whether vital exhaustion is a precursor of first stroke while controlling for other cardiovascular risk factors. The design was a prospective cohort study. Vital exhaustion was diagnosed with the Maastricht Interview Vital Exhaustion scale. The authors controlled for age, gender, diabetes mellitus, systolic and diastolic blood pressure, total cholesterol, body mass index, and smoking habits as possible confounders. Data were analyzed with Cox regression analysis. The subjects were adults ages 41-66 in an average Dutch village population. Outcome measures included first stroke. Vital exhaustion increased the risk of stroke by 13% per vital exhaustion point on the Maastricht Interview Vital Exhaustion scale. This value remained statistically significant after control for other risk factors. Total cholesterol, diastolic blood pressure, systolic blood pressure, diabetes mellitus, and smoking also increased the risk of stroke significantly. A state of exhaustion is one of the risk indicators for stroke. This means that the fatigue so often seen after stroke was already experienced by many patients before the occurrence of the stroke.     

Ischemic Stroke among the Patients with End-Stage Renal Disease Who Were Undergoing Maintenance Dialysis

Purpose: In spite of higher incidence of stroke in end-stage renal disease (ESRD) patients compared to general population, the risk factor for stroke which is specific to ESRD is not fully understood. The ESRD patients who develop stroke may have certain additional risk factors compared to ESRD patients without stroke. We used registered data of Hallym Stroke Registry to elucidate the factors which affect development of ischemic stroke among the dialysis patients. Materials and Methods: We recruited patients with acute ischemic stroke in ESRD patients undergoing maintenance dialysis. Dialysis patients without stroke were selected as control group with age and gender matching. We compared the demographic features, stroke risk factors, and laboratory findings in ESRD patients with or without ischemic stroke. Results: The total of 25 patients with ESRD developed ischemic stroke. Fifty ESRD patients without stroke were chosen as the control group. The mean age of acute ischemic stroke patients was 59.80±9.94 and male gender was 48%. The most common ischemic stroke subtype was small vessel occlusion (n=12), followed by large artery atherosclerosis (n=7). The patients with stroke had more frequent history of hypertension and higher systolic/diastolic blood pressure at the time of admission than the ESRD patients without stroke. Total cholesterol and LDL-cholesterol levels were significantly lower in the stroke group. In multivariate analysis, LDL-cholesterol was found to be the only risk factor for ischemic stroke. Conclusion: The results of our study reveal that LDL-cholesterol is associated with greater risk for ischemic stroke in the patients on dialysis.     

Vascular risk factors and dementia in the general population aged >85 years: prospective population-based study

The aim of this study was to evaluate the association between dementia and common vascular risk factors including blood pressure, blood lipids, homocysteine and diabetes mellitus in a population of very old people. This study is a 9-year follow-up prospective population-based study monitoring 339 non-demented subjects aged 85 years or over in the city of Vantaa, Southern Finland. During the follow-up, those individuals with diabetes mellitus at the baseline and new incident stroke had a higher probability for developing dementia. History of hypertension or higher level of education were associated with a lower probability of dementia. It seems that the contribution of vascular risk factors to the risk of dementia may be age-dependent and their role in the very old subjects may be mediated through their influence on cerebrovascular morbidity. Thus, prevention of stroke and diabetes mellitus may reduce the risk of cognitive decline in the very old.     

LOX-1在2型糖尿病下肢动脉硬化闭塞症中的表达及其作用

目的:观察2型糖尿病下肢动脉硬化闭塞症中血凝素样氧化低密度脂蛋白受体-1(LOX-1)mRNA和蛋白表达,并探讨其作用机制。方法:对9例2型糖尿病下肢动脉硬化闭塞症患者(糖尿病组)和7例正常肾移植供肾者(对照组)动脉标本行HE染色,应用RT-PCR和Western-blot检测动脉组织匀浆中LOX-1的mRNA和蛋白水平。结果:与对照组相比,糖尿病组LOX-1mRNA和蛋白水平表达明显升高(P0.05)。结论:2型糖尿病患者可能通过上调LOX-1表达而更容易合并下肢动脉硬化闭塞症,LOX-1可能是动脉硬化闭塞症发生发展的一个关键因素。     

The Relationship between Brachial Ankle Pulse Wave Velocity and Complement 1 Inhibitor

Complement 1 (C1) inhibitor is an acute phase protein with anti-inflammatory properties. The aim of the present study was to elucidate the relationship between brachial ankle pulse wave velocity (baPWV), the parameter of arterial stiffness, and C1 inhibitor. One hundred subjects were randomly enrolled in this study. Data about baPWV, age, gender, hypertension, smoking, and body mass index (BMI) were measured. Blood tests for total cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, hemoglobin A1c, erythrocyte sedimentation rate, C-reactive protein, complement 3, and C1 inhibitor were performed. Based on the Pearson correlation, the C1 inhibitor showed a positive relation to the baPWV (P<0.001). Multiple regression analysis revealed the significant predictors of baPWV were not only the conventional risk factors of arteriosclerosis and/or atherosclerosis, such as age (P<0.001), gender (P<0.001), hypertension (P<0.001), and BMI (P=0.006), but also the acute phase protein, C1 inhibitor (P=0.025). In conclusion, C1 inhibitor is associated with arterial stiffness through its association with increased inflammation.     

缺血性脑卒中影响因素的条件Logistic回归分析

目的应用条件Logistic回归模型探讨深圳市缺血性脑卒中的危险因素，为制定相关政策和措施提供科学依据。方法采用1：1配比的病例对照研究设计，选择深圳市两家综合性医院的309例缺血性脑卒中患者为病例组，同时选择年龄、性别匹配309例健康者作为对照组，对研究因素进行单因素及多因素条件Logistic回归分析。结果高血压、吸烟、家庭压力和高血糖是缺血性脑卒中的危险因素。OR值分别为3．507、5．420、3．990和1．183；而饮茶、体育锻炼是缺血性脑卒中的保护因素，OR值分别为0．250、0．100。结论在脑卒中的社区防治中，应尽早、及时地控制高血压、吸烟和体重，同时培养健康的生活方式是预防缺血性脑卒中发生的重要措施。     

Clinical significance of serum LpA-I levels measured by immunoturbidimetric assay in type 2 diabetes mellitus patients

Previously, we developed an immunoturbidimetric assay method for lipoprotein A-I(LpA-I) on sera pre-absorbed with anti-apolipoprotein A-II. In the present study, correlations between serum lipoprotein A-I and other serum parameters levels were examined and LpA-I levels were studied in patients with type 2 diabetes mellitus. The serum levels of LpA-I did not correlate with those of diabetic markers such as fasted blood glucose, glycohemoglobin(HbA1c) and fructosamine, but correlated well with the levels of total cholesterol and HDL cholesterol, phospholipids, apolipoprotein A-I and seemed to correlate inversely with arteriosclerosis index. In patients with type 2 diabetes mellitus, LpA-I levels were significantly lower than those in normal subjects. Especially, LpA-I levels of patients with diabetic complications were significantly lower than those in normal subjects and non-complicated diabetic patients. Then, the measurement of LpA-I levels in patients with type 2 diabetes mellitus was considered to be useful for prevention and management of arteriosclerosis.     

Sleep apnea in acute cerebrovascular diseases: final report on 128 patients

Although obstructive sleep apnea (OSA) appears to be a cardiovascular risk factor, its frequency in patients with transient ischemic attack (TIA) and stroke remains poorly known. We prospectively studied 128 patients (mean +/- SD age = 59 +/- 15 years) with stroke (n = 75) or TIA (n = 53). Assessment included body mass index (BMI); history of snoring and daytime sleepiness; cardiovascular risk factors and diseases; and severity of stroke (Scandinavian Stroke Scale = SSS). Polysomnography (PSG) was obtained in 80 subjects (group 1), a mean of 9 days (range, 1-71 days) after TIA or stroke. In 48 subjects (group 2), PSG was not available, refused, or inadequate. Groups 1 and 2 were similar with the exception of gender distribution. Clinical and PSG data were compared to those of 25 healthy controls matched for age, gender, and BMI. An apnea-hypopnea index (AHI) > 10 was found in 62.5% of subjects and 12.5% of controls. Between patients and controls there was a significant difference in AHI (mean [range]: 28 (0-140) vs 5 (0-24), p < 0.001), maximal apnea duration (mean + SD: 37 +/- 23 vs 23 +/- 13 seconds, p = 0.009), and minimal oxygen saturation (mean + SD: 82 +/- 10% vs 90 +/- 5%, p < 0.001). Conversely, frequency and severity of OSA were similar in stroke and TIA subjects. Multiple regression analysis identified age, BMI, diabetes, and SSS as independent predictors of AHI. Sleep apnea has a high frequency in patients with TIA and stroke, particularly in older patients with high BMI, diabetes, and severe stroke. These results may have implications for prevention, acute treatment, and rehabilitation of patients with acute cerebrovascular diseases.     

Immunology of elastin: study of anti-elastin peptide antibodies by DOT immunobinding assay

In order to further investigate the role of the immune system in the arteriosclerotic process, we investigated the anti-elastin peptide antibodies (AEAb) of the IgG and IgM types by DOT immunobinding assay in the sera of patients suffering from various arteriosclerotic diseases. In total 232 control and pathological sera were studied. In obliterative arteriosclerosis of the legs 90%, ischemic heart disease 67% and hypertension 60% of sera were positive for AEAb of the IgG type independent of age. In the case of diabetes mellitus, however, the duration of the disease was determinant. In rheumatoid arthritis, the results were negative. No clear-cut positivity could be demonstrated in stroke patients either. These results indicate that AEAb can be detected in some diseases and DOT appears to be an appropriate method for the AEAb screening in various diseases.     

Antibodies to oxidized LDL and LDL-containing immune complexes as risk factors for coronary artery disease in diabetes mellitus

Several groups have published results from clinical studies supporting the involvement of anti-modified LDL antibodies as risk factors for the initiation or progression of cardiovascular disease. However, the data published so far are judged inconclusive because of several contradictory observations concerning the correlation between clinical evidence of arteriosclerosis and the levels of antibodies to oxidized LDL (oxLDL Ab). We have previously reported that oxLDL Ab exist both in free form and as antigen-antibody complexes (LDL-IC) in patients with insulin-dependent diabetes mellitus (IDDM). The presence of LDL-IC in IDDM patients has important implications: it may interfere with the assay of oxLDL antibodies and the levels of LDL-IC may correlate better with the development of arteriosclerosis than the levels of free oxLDL antibodies. To clarify these questions baseline samples collected from 49 IDDM patients, who subsequently developed coronary artery disease (CAD) during an 8-year follow-up period, were compared to baseline samples from 49 age-, sex-, and duration-matched control IDDM subjects who remained free of clinical CAD during an identical follow-up period. The levels of free oxLDL antibody were significantly lower in the patients who developed CAD. The same patients had significantly higher concentrations of total cholesterol, apolipoprotein B, and IgA in immune complex-enriched polyethylene glycol (PEG) precipitates. The concentration of IgG was also higher in PEG precipitates from patients who developed CAD, but did not reach statistical significance. This indicates that patients who develop CAD had higher levels of circulating LDL-IC, a fact that could not be deduced from the measurement of free oxLDL antibody concentrations. A linear regression analysis of the correlation between the concentrations of total cholesterol in PEG precipitates, taken as a surrogate measurement of PEG-precipitated oxLDL-IC, and the concentration of free oxLDL antibody in serum showed a statistically significant negative correlation (r = -0.229, P = 0. 024). Our results support the conclusion that oxLDL-IC may be a risk factor for the development of macrovascular disease in IDDM patients. We also have demonstrated that circulating oxLDL-IC interfere with the assay of free oxLDL antibodies.     

The assessment of arteriolosclerosis by serum lipids data, and carotid ultrasonography and pulse wave velocity, and its evaluation as a tool for preventive medicine: II. Carotid ultrasonography and pulse wave velocity for hyperlipemia and diabetes mellitus

We studied the test results of carotid ultrasonography and pulse wave velocity against a sample of hyperlipemia and diabetes mellitus. Sixty four hyperlipemia samples (HL), 85 diabetes mellitus samples (DS), and 27 complicated samples (CS) were compared with 56 healthy samples (HS). Hyperlipemia samples were selected from cholesterol under 300 mg/dl, and neutral fat under 300 mg/dl. Diabetes mellitus samples were selected from fasting plasma glucose (FBS) under 200 mg/dl. Samples from severe conditions with various disease were excluded. Ratio over 1.1 mm intima-media thickness (IMT) was 0% in HS, 48% in HL, 40% in DS and 33% in CS. PWV value was max 1896cm/s in CS. There was no significant correlation within IMT, serum lipid(Total Cholesterol, Neutral Fat, HDL-Cholesterol, LDL-Cholesterol) and FBS. For early treatment or accurate diagnosis of arteriosclerosis in hyperlipemia or diabetes mellitus patients, who are at high risk of developing arteriosclerosis, to vital function tests (carotid ultrasonography and pulse wave velocity) should be performed, in addition to normal blood tests.     

Genetic risk factors for ischemic cerebrovascular disease--analysis on fifteen candidate prothrombotic gene polymorphisms in the Japanese population

Accumulating evidence suggests that several polymorphisms in factors regulating blood coagulation, platelet function, and lipid metabolism are relevant for susceptibility to ischemic cerebrovascular diseases (CVD). The present study analyzed 15 genetic polymorphisms possibly associated with atherosclerosis and thrombosis in a case-control study involving a total of 200 genetically unrelated Japanese patients with ischemic CVD (mean age 58.3 +/- 7.6 y) and 281 age- and gender-matched control subjects (59.0 +/- 4.1 y). Control subjects were randomly selected from unrelated donors with no history of documented CVD or any type of cardiovascular disease with normal resting electrocardiograms. Among the factors genotyped, two factors, platelet glycoprotein (GP) Ib alpha (Thr145Met) and NADPH oxidase p22phox (His72Tyr), were significantly associated with CVD after adjustment for acquired risk factors including hypertension, diabetes mellitus, hyperlipidemia, and smoking. For those with age < 60 y, 10.6% of the CVD patients and 2.9% of the control subjects had both of the two risk genotypes (GPIb alpha 145Met and p22phox 72Tyr, p < 0.05). The mean onset-age of CVD was 58.6 +/- 7.7 y for those having no or only one risk genotype, while 53.3 +/- 5.5 y for those having both of the risk genotypes (p < 0.05). Thus, GPIb alpha 145Met and p22phox 72 Tyr are the genetic factors associated with the risk of ischemic CVD in the Japanese. Carrying both of the two mutations might be associated with developing CVD at a younger age.     

慢性肾脏病血清镁离子水平与动脉硬化及左心室功能的相关性

目的探究慢性肾脏病患者血清镁离子水平与动脉硬化、左心室功能的相关性。方法将2017年1月至2018年12月我院肾内科住院的200例慢性肾脏病患者分为CKD1期组(12例)、CKD2期组(38例)、CKD3期组(74例)、CKD4期组(55例)、CKD5期组(21例),比较各组患者一般生化指标、动脉硬化指标及左心室功能指标并分析镁离子与不同分期患者指标的相关性。结果(1)随着CKD分期的升高,慢性肾病患者三酰甘油(TG)、低密度脂蛋白(LDL-C)、血清磷、血肌酐(Scr)、尿素氮(BUN)等一般生化指标升高(P<0.05),血清钙逐渐降低(P<0.05);各组患者血清镁离子比较差异具有统计学意义(P<0.05),CKD1~4期患者比较差异无统计学意义(P>0.05),CKD5期患者显著高于其他组别(P<0.05)。(2)各组患者踝臂指数(ABI)、臂踝脉搏波传导速度(baPWV)比较差异具有统计学意义(P<0.05),其他指标比较差异无统计学意义(P>0.05)。(3)CKD1~3期患者血清镁离子水平与动脉硬化指标及心功能指标均无明显相关性(P>0.05);CKD4~5期患者血清镁离子水平与ABI、趾臂指数(TBI)及二尖瓣环舒张早期峰值速度(VE)呈正相关(P<0.05)。结论血清镁离子水平与慢性肾脏病晚期患者动脉硬化、左心功能存在密切关系,临床宜重视镁离子平衡的干预,降低与之相关的并发症发生率。     

2型糖尿病合并甲状腺功能减退的影响因素分析研究

目的：探究2型糖尿病(type 2 diabetes mellitus,T2DM)合并甲状腺功能减退的影响因素。方法：选择2013年1月至2015年6月在我院接受治疗的2型糖尿病患者784例。将2型糖尿病合并甲状腺功能减退的71例患者作为甲减组,甲状腺功能正常的713例患者作为T2DM组。比较甲减组和T2DM组患者的临床资料,用单因素分析和Logistic回归分析其影响因素。结果：2型糖尿病合并甲状腺功能减退的发病率为9.06%,其中临床甲减16例,为2.04%,亚临床甲减55例,为7.02%。比较甲减组与T2DM组患者的一般临床资料,发现2型糖尿病合并甲状腺功能减退与年龄、糖尿病病程、ABI、FCP、E/A、TC、TG、LDL-C、Lp(a)、S-CRP、UAER、TPO-Ab、性别、吸烟、冠心病、DN、DNP、DR、DF、PAD、DM治疗方式有关(P<0.05)。将2型糖尿病患者是否合并甲状腺功能减退作为因变量,将上述因素纳入Logistic多元回归分析,结果显示年龄、吸烟、胰岛素治疗、TPO-Ab是2型糖尿病患者合并甲状腺功能减退的独立危险因素。结论：年龄、吸烟、胰岛素治疗、TPO-Ab是2型糖尿病患者合并甲状腺功能减退的独立危险因素,2型糖尿病患者应定期进行甲状腺功能检查,以便及早诊断和干预甲状腺功能减退。     

Genetic analysis of HLA, NA and HPA typing in type 2 diabetes and ASO

We examined the genetic status of human leucocyte antigens (HLA), human platelet alloantigens (HPA) and neutrophil-specific antigens (NA) in patients with type 2 diabetes mellitus and diabetic arteriosclerosis obliterans (ASO). To our knowledge, the present study is the first report showing the relationship among three genetic factors in type 2 diabetes mellitus and ASO patients. HLA typing was performed by the polymerase chain reaction (PCR)-restriction fragment length polymorphism method. HPA-typing and NA-typing were by a PCR-sequence-specific primer method. The incidence of HLA-DRB1*1501 was found to be significant in type 2 diabetes and non-diabetic, particularly ASO-positive patients, compared to control subjects. There were no differences in NA1/NA2 between the control and diabetic or non-diabetic ASO groups. However, the frequency of NA2/NA2 in ASO-positive diabetes and non-diabetic ASO patients was significantly higher than controls. The a/b genotype of HPA-5a/5b was significantly lower in type 2 diabetes and non-diabetic ASO-positive patients than in controls. These findings suggest that genetic studies of HLA, NA and HPA could be useful to understand the pathogenesis of type 2 diabetes and ASO.