2型糖尿病患者血清生长分化因子-15的水平及其与大血管病变的关系

目的:探讨血清生长分化因子(GDF)-15与2型糖尿病(T2DM)及T2DM合并大血管病变的关系.方法:选择60例初发T2DM患者,根据是否合并大血管病变分为A组(单纯T2DM) 30例,B组(T2DM合并大血管病变)30例,另选择30例体检健康老年人作为正常对照(C组);记录年龄、身高、体重,测量血压、腰围、臀围,计算体制指数(BMI)、臀腰比(WHR),检测血清GDF-15、血脂、糖化血红蛋白(HbA1c)及超敏C反应蛋白(hsCRP)水平;对检测结果进行统计学处理,分析其影响因素.结果:A组及B组血清GDF-15水平均高于C组;B组血清GDF-15水平高于A组;GDF-15水平与WHR、SBP、TC、TG、LDL、HbA1c、hsCRP呈正相关,与HDL呈负相关;多元线性逐步回归分析显示hsCRP、LDL是影响血清GDF-15水平的主要因素.结论:血清GDF-15在T2DM及T2DM合并大血管病变中均升高,且在T2DM合并大血管病变中升高更为明显.GDF-15可能通过脂质代谢和炎症反应等多个环节参与2型糖尿病及其大血管病变的发生发展.

Serum Level of Growth Differentiation Factor-15 in Type 2 Diabetes Mellitus and Its Relation to Macro Vascular Complications

Objective: To investigate the level of growth differentiation factor-15(GDF-15) in the serum of patients with type 2 diabetic mellitus(T2DM) and its relation to macro vascular(MV) complications.Methods: Sixty patients with T2DM were divided into non-MV complication group(group A,n=30) and MV complications group(group B,n=30),and 30 normal old persons were also enrolled as control group(group C,n=30).Age,height,weight,waist circumference,hip circumference,and serum levels of GDF-15,blood lipids,glycated hemoglobin and high sensitivity C-reactive protein(hsCRP) were investigated,and results were statistically analyzed to find the influencing factors.Results: The serum levels of GDF-15 in group A and group B were higher than in group C,and the level of GDF-15 in group B was higher than in group A(P<0.05).The level of GDF-15 was positively correlated with WHR,SBP,TC,TG,LDL,HbA1c,hsCRP,and negatively correlated with HDL.Taking GDF-15 as the dependent variable,and age,sex,BMI,WHR,SBP,DBP,TG,TC,LDL,HDL,HbA1c,and hsCRP as independent variables for multiple linear stepwise regression analysis,the result had shown that hsCRP and LDL were the major factors that affect the GDF-15 level in serum.Conclusion: The serum level of GDF-15 increased in type 2 diabetic patients,especially in patients with macro vascular complication,indicating that GDF-15 may be a risk factor for type 2 diabetes and macro vascular disease.