2型糖尿病患者血清淀粉样蛋白A与糖尿病大血管病变的关系

目的探讨分析2型糖尿病(typeⅡdiabetes mellitus,T2DM)患者血清淀粉样蛋白A(serum amyloid A,SAA)与糖尿病大血管病变的相关性。方法选择2017年3月至2018年3月北京市中西医结合医院收治的T2DM患者78例,按照患者是否合并大血管并发症分为T2DM大血管并发症组(并发症组)31例以及T2DM无并发症组(无并发症组)47例,再选择健康志愿者40名作为对照组。检测各组受试者血清SAA、C-反应蛋白(C-reactive protein,CRP)浓度以及血糖、血脂浓度,比较3组受试者各指标变化情况,并分析糖尿病患者SAA浓度与生化指标的相关性。结果3组患者三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(hemoglobin A1C,HbAlc)以及胰岛素抵抗指数(homeostasis model assessment insulin resistance,HOMA-IR)比较,差异具有统计学意义(P<0.05);其中无并发症组、并发症组患者TG、TC、FBG、HbAlc以及HOMA-IR均显著高于对照组,差异有统计学意义(P<0.05);且并发症组TG、TC、FBG、HbAlc以及HOMA-IR显著高于无并发症组,差异有统计学意义(P<0.05)。3组受试者SAA、CRP比较,差异具有统计学意义(P<0.05);其中无并发症组患者SAA、CRP显著高于对照组,差异具有统计学意义(P<0.05);而并发症组患者SAA、CRP显著高于无并发症组,差异具有统计学意义(P<0.05)。糖尿病患者SAA与TG、TC、FBG、HbAlc、HOMA-IR、CRP均呈显著正相关关系(P<0.05)。结论炎症因素在T2DM大血管病变患者中具有重要影响,SAA浓度与T2DM大血管病变密切相关,可能是T2DM大血管病变的重要危险因素,对患者临床监测及大血管病变防治方案的拟定具有重要价值。

Relationship between serum amyloid A and diabetic macroangiopathy in patients with type 2 diabetes mellitus

Objectives To investigate the relationship between serum amyloid A(SAA)and diabetic macroangiopathy in patients with typeⅡdiabetes mellitus(T2DM).Methods Seventy-eight patients with T2DM admitted to Beijing Institute of Chinese and Western Medicine Hospital from March 2017 to March 2018 were enrolled.According to whether the patients had major vascular complications,they were divided into T2DM macrovascular complications group(com?plication group,n=31)and T2DM without complications group(non-complication group,n=47).At the same period,40 healthy volunteers were selected as control group.Serum concentrations of SAA,C-reactive protein(CRP),blood glucose and blood lipids were measured in each group.The changes of each index in the three groups were compared,and the concentrations of SAA in diabetic patients were analyzed.Results Differences of concentrations of triglyceride(TG),total cholesterol(TC)fasting blood glucose(FBG),hemoglobin A1C(HbAlc)and homeostasis model assess?ment insulin resistance(HOMA-IR)among the three groups were statistically significant(P<0.05).Concentrations of TG,TC,FBG,HbAlc and HOMA-IR were significantly higher in non-complication group and complication group than those in control group(P<0.05).Concentrations of TG,TC,FBG,HbAlc and HOMA-IR were significantly higher in complication group than in non-complication group(P<0.05).Concentrations of SAA and CRP were higher in non-complication group than in control group(P<0.05).There were significant positive correlations between SAA and TG,TC,FBG,HbAlc,HOMA-IR and CRP in patients with T2DM(P<0.05).Conclusions Inflammatory factors play an important role in patients with T2DM macroangiopathy.Concentration of SAA closely related to T2DM macroan?giopathy.Concentration of SAA may be an important risk factor for T2DM macroangiopathy.It is of great value for clini?cal monitoring and formulation of prevention and treatment plan of macroangiopathy.