冠心病合并2型糖尿病血清视黄醇结合蛋白4水平与冠状动脉病变程度的相关性研究

目的研究合并2型糖尿病的冠心病患者冠状动脉病变程度与血清视黄醇结合蛋白4（retinol-bindingprotein 4,RBP4）水平的相关性。方法 2008年10月2010年4月选择性冠状动脉造影确诊的冠心病患者共120例,分为单纯冠心病组（A组）60例和冠心病合并糖尿病组（B组）60例,检测血糖、血脂、胰岛素以及脂联素、RBP4水平;根据冠状动脉造影结果,以Gensini评分评判冠状动脉病变程度。结果 B组空腹血糖、胰岛素、RBP4均显著高于A组（P〈0.05）;冠状动脉病变程度更重（P〈0.05）。相关性分析显示RBP4水平与低密度脂蛋白胆固醇、胰岛素抵抗和冠状动脉病变积分呈正相关（r=0.312、0.322、0.314,P〈0.05）。与脂联素水平呈负相关（r=-0.362,P〈0.01）。结论冠心病合并2型糖尿病患者RBP4明显升高,且与冠状动脉狭窄程度呈正相关。

Relationship between the Level of Serum Retinol-Binding Protein 4 and the Extent of Coronary Lesions in Coronary Heart Disease Accompanied with Type 2 Diabetes Mellitus

Objective To explore the relationship between the level of serum retinol-binding protein 4（RBP4） and the extent of coronary lesions in coronary heart disease（CHD） patients accompanied with type 2 diabetes mellitus（T2DM）.Methods A total of 120 patients with CHD diagnosed by coronary arteriongraphy between October 2008 and April 2010 were enrolled.The patients were divided into two groups： CHD group（60 patients）;CHD accompanied with T2DM group（60 patients）.The levels of serum insulin,adiponectin and RBP4 were measured.All the patients underwent coronary angiography and the extent of coronary lesions was assessed quantitatively based on the Gensini′s scoring system.Results The levels of serum insulin,plasma RBP4 and the extent of coronary artery stenosis in CHD accompanied with T2DM group were significantly higher than those in CHD group（P0.05）.Correlation analysis showed that the level of RBP4 was positively correlated with LDL-C,insulin resistance index and the coronary artery narrow degree（r=0.312,0.322,0.314;P0.05）;and negatively correlated with adiponectin（r=-0.362,P0.01）.Conclusion The significant elevated plasma RBP4 in CHD patients accompanied with T2DM is positively correlated with the extent of coronary artery lesion.