对氧磷酯酶1与2型糖尿病并发冠心病相关因素分析

目的　分析对氧磷酯酶 1(PON1)的活性与 2型糖尿病各种相关因素 (血压、血脂、血糖、病程等 )的相互关系 ,研究PON1活性变化对 2型糖尿病并发冠心病的影响。方法　以对氧磷 (paraoxon)为底物 ,测定 4 9例对照组、10 3例2型糖尿病患者空腹血清PON1活性 ,同时测定各组血脂、血糖、血压、肝功能、肾功能等。结果　对照组血清PON1的活性明显高于 2型糖尿病组 ,差别有显著性意义 (P <0 0 1)。 2型糖尿病组TC、TG高于对照组 ,有显著性差异 (P <0 0 1)。 2型糖尿病并发冠心病组血清PON1活性低于 2型糖尿病无并发症组 (P <0 0 1)。 2型糖尿病并发冠心病组的TC、LDL高于无并发症组 (P <0 0 5 )。相关分析 :PON1活性与TC、LDL呈负相关 (P <0 0 1)。PON1活性与HDL呈正相关 (P <0 0 5 )。PON1活性与收缩压、舒张压均呈负相关 (P <0 0 5 )。TC、LDL、收缩压和PON1为 2型糖尿病并发冠心病的危险因素。对照组血清PON1活性为 10～ 70 8IU/L ,2型糖尿病组为 4～ 4 76IU/L。结论　血清PON1活性与2型糖尿病并发冠心病明显相关。PON1活性、收缩压、总胆固醇、LDL是 2型糖尿病并发冠心病的重要危险因素。

On the Relative Factors of Paraoxonase 1 and Type 2 Diabetes Mellitus with Coronary Artery Disease

Objective To study the relationship between the activity of paraoxonase 1 (PON1) and various factors (blood pressure,blood lipid,blood glucose, case history) in type 2 diabetes mellitus (type 2 DM) with coronary artery disease(CAD),meanwhile,to study the effect of activity of PON1 in type 2 DM with CAD.Methods The fasting serum PON1 activity were measured,either in 49 controls or in 103 type 2 DM,by using paraoxon as a substrate;and fasting blood glucose,blood lipid were measured too. Blood pressure,liver function and kidney function were measured.Results PON1 activity in controls were higher significantly than one in type 2 DM patients (P<0.01).TC,LDL in type 2 DM patients were higher than in controls(P<0.01);HDL in controls was higher than in type 2 DM,but it did not reach statistical significance. PON1 activity in type 2 DM with CAD was lower than that in type 2 DM without CAD(P<0.01).TC,LDL concentration in the type 2 DM with CAD were higher than one in the type 2 DM without CAD(P<0.05). PON1 activity had negative correlation with TC,LDL,coefficient r were -0.510,P<0.01;-0.063,P<0.01. PON1 activity had positive correlation with HDL,r was 0.331,P<0.05. PON1 activity had negative correlation with SBP and DBP,coefficient r were -0.54,P<0.01;-0.29,P<0.05 respectively. TC, LDL,SBP and PON1 were the dangerous factors of T 2DM with CAD. Distribution of PON1 activity level in the subjects showed that activity of PON1 in controls was 10-708 IU/L, in the patients of type 2 DM was 4-476 IU/L.Conclusion Serum PON1 activity was relative to type 2 DM with CAD. PON1 activity,TC, SBP and LDL were the important dangerous factors of type 2 DM with CAD.