2型糖尿病患者血清PCSK9与动脉粥样硬化指标的相关性分析

目的:研究2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin/kexin 9,PCSK9)与动脉粥样硬化(atherosclerosis,AS)指标的相关性?方法:对351例T2DM患者进行病史采集?颈部及下肢血管彩色多普勒检查,测定其PCSK9水平?结果:T2DM合并AS组患者的血清PCSK9水平高于T2DM无AS组(P < 0.05),血清PCSK9水平与T2DM患者的颈总动脉内中膜厚度(carotid artery intima-media thickness,CIMT)呈正相关(P < 0.01),与右侧颈总动脉(RCCA)内径?RCCA峰值/次峰值(PI)?右侧颈内动脉(RICA)PI?左侧颈总动脉(LCCA)PI?左侧颈内动脉(LICA) PI?RICA 阻力指数(RI)?LCCA RI等颈动脉粥样硬化相关性指标呈正相关(P < 0.05),而与RCCAVmax?RCCA Vmin?RCCA Tamx等指标呈负相关(P < 0.05)?结论:T2DM患者血清PCSK9水平与评估AS程度的指标密切相关,可能成为临床预测及评估T2DM患者AS相关大血管疾病发生风险的指标?

Correlation analysis between serum PCSK9 and the risk factors of atherosclerosis

Objective:To study the correlation between serum proprotein convertase subtilisin/kexin 9 (PCSK9) and the risk factors of atherosclerosis (AS) in patients with type 2 diabetes mellitus (T2DM). Methods:Fasting blood samples were obtained from 351 T2DM patients enrolled in the department of endocrinology and metabolism of Jiangsu Province Hospital between January 2011 to November 2011. History-taking, physical and biochemical examinations, and the severity of carotid artery and artery of lower extremity atherosclerosis assessment were examined. Serum PCSK9 was measured with a sensitive and specific sandwich ELISA. Results:The level of serum PCSK9 in patients with T2DM combined with AS was higher than that in T2DM patients without AS (P < 0.05). Besides,there was also a positive correlation between serum PCSK9 and varied carotid AS related-index,such as RCCA inside diameter,RCCA PI,RICA PI,LCCA PI,LICA PI,RICA RI,LCCA RI (all P < 0.05). Furthermore,a negative association was found between the serum PCSK9 and RCCA Vmax,RCCA Vmin,RCCA Tamx, in this population (all P < 0.05). Conclusion:The level of serum PCSK9 is strongly correlated with several risk factors of AS. In combination with traditional risk factors of AS,serum PCSK9 will provide more information for predicting the presence of AS-related cardiovascular diseases.