2型糖尿病脂联素水平与心脑血管病变关系的研究

目的 探讨血清脂联素与2型糖尿病（T2DM）心脑血管病变的关系.方法 选健康体检者（A组）35例,单纯糖尿病（B组）42例,糖尿病合并心脑血管病变（C组）38例,测定各组血清脂联素水平及其血糖、血脂、空腹胰岛素等指标,计算胰岛素抵抗数;测定反映心脑血管粥样硬化的早期指标-颈动脉内膜中层厚度（CIMT）,进行统计学分析.结果 （1）B组脂联素水平低于A组（P〈0.01）,C组脂联素水平低于A组及B组（P〈0.01）,B、C组患者均比A组存在明显的代谢紊乱和胰岛素抵抗.（2）脂联素与CIMT的变化呈显著负相关（P〈0.01）.（3）多元线性逐步回归分析提示：脂联素及高密度脂蛋白胆固醇降低、甘油三酯增高是T2MD患者CIMT增厚的危险因素.结论 血清脂联素水平降低是2型糖尿病患者动脉粥样硬化的独立危险因子之一,能够改善胰岛素抵抗、调节血糖血脂、降低血压、延缓T2DM的大血管动脉粥样硬化等作用,对糖尿病心脑血管病变起到保护作用.

The relationship between adiponectin and cardiac and cerebral angiopathy in the patients with type 2 diabetes menitus

Objective To analyze the relationship between adiponectin and the cardiac and cerebral anglopathy in the patients with type 2 diabetes mellitus （T2DM）. Methods There was three groups：35 examined heahhy persons were enrolled in this study as control group （ group A） ; the group B was composed of the diabetic patients without macroangiopathy（n = 42）;the group C was composed of the diabetic patients with the cardiac and cerebral vascular complication （ n = 38 ）. Their serum adiponectin （ ADP）, blood glucose, blood lipid, fasting inlusin were deter- mined. The insulin resistance index（IRI） was calculated. The carotid intima-media thickness （CIMT） was measured. The results were analyzed. Results （ 1 ） The level of serum adiponectin of group B was lower than that of group A（ P 〈 0. 01 ）, Group C had the lowest level of adiponectin among 3 groups （ P 〈 0. 01 ）. The patients in group B and C had more evident metabolic disturbance and insulin resistance than group A. （2） ADP was negatively correlated with CIMT（ P 〈 0. 01 ）. （3） Multiple linear stepwise regression analysis suggested that decrease of adiponectin and high-density lipoprotein cholesterol and the increase of triglycerides were the dangerous factors of CIMT thickening. Conclusion Lower adiponectin concentration is one of the independent dangerous factors for atherosclerosis in the type 2 diabetes patients. It can improve insulin resisitent, regulate blood glucose and blood lipid,lower blood pressure, slow down the atherosclerosis of diabetes, protect the patients with type 2 diabetes against the cardiac and cerebral vascular disease.