血清脂肪细胞型脂肪酸结合蛋白和白细胞介素-17水平与2型糖尿病患者下肢动脉粥样硬化病变的相关性研究

目的 探讨 2 型糖尿病下肢动脉粥样硬化病变(LEAD)患者外周血脂肪细胞型脂肪酸结合蛋白( A-FABP)、白细胞介素-17(IL-17)浓度变化及其临床意义.方法 选取129例2型糖尿病患者,根据踝肱指数( ABI)分为糖尿病无下肢动脉粥样硬化病变组(NLEAD组,n=90)和糖尿病下肢动脉粥样硬化病变组(LEAD组,n=39).另选择40例健康人群作为对照组 ( NC 组),检测各组外周血 A-FABP、IL-17浓度,比较各组间A-FABP、IL-17水平差异.应用Pearson相关分析,探讨影响血清A-FABP、IL-17浓度的相关影响因素;应用Logistic回归分析,了解A-FABP、IL-17 是否为糖尿病周围血管病变的独立影响因素.结果 NLEAD组、LEAD组的A-FABP、IL-17水平较NC组显著升高,LEAD组A-FABP、IL-17 水平较 NLEAD 组显著升高( P ＜0. 05).Pearson相关分析显示,A-FABP与体质量指数( BMI)、糖化血红蛋白(HbA1c)、收缩压(SBP)、胰岛素抵抗(HOMA-IR)、血肌酐(SCr)、白细胞介素-17(IL-17)均呈正相关性(r =0. 224、0. 164、0. 147、0. 183、0. 173、0. 203,P＜0. 05);IL-17与LDL-c、HbA1c、SBP均呈正相关性(r=0. 162、0. 255、0. 152,P＜0. 05). Logistic 逐步回归分析表明,低密度脂蛋白胆固醇、A-FABP、IL-17为LEAD发病的独立危险因素.结论 2型糖尿病合并LEAD患者外周血A-FABP、IL-17水平明显增加,与LEAD发病密切相关.

The study on the correlation between serum adipocyte fatty acid binding protein and interleukin 17 levels and lower extremity atherosclerotic disease in type 2 diabetes

Objective To investigate the relationship between serum adipocyte fatty acid binding protein ( A-FABP) and interleukin 17 (IL-17) levels and lower extremity atherosclerotic disease (LEAD) in type 2 diabetes patients. Methods According to ankle-brachinal index, a total of 129 patients with type 2 diabetes mellitus were divided into diabetic lower extremity atherosclerotic disease ( LEAD) group (39 cases) and non-diabetic lower ex-tremity atherosclerotic disease ( NLEAD ) group (90 cases) . In addition, 40 cases of healthy persons were select-ed as control group ( NC group) . The serum levels of A-FABP and IL-17 were analysed and compared among three groups. Pearson correlation analysis were used to explore which factors influence on the serum level of A-FABP and IL-17. Logistic regression analysis were carried out to evaluate whether A-FABP and IL-17 were independent influ-encing factors of LEAD. Results Serum level of A-FABP and IL-17 were higher in NLEAD group than that in NC group, Serum level of A-FABP and IL-17 were higher in LEAD group than in NLEAD group (P＜0. 05). Pearson correlation analysis showed that the level of serum A-FABP was positively correlated with both body mass index, he-moglobin A1c, systolic blood pressure, homeostasis model assessment for insulin resistance, serum creatinine, and IL-17(r=0. 224, 0. 164, 0. 147, 0. 183, 0. 173, 0. 203, respectively, P＜0. 05). In addition, Pearson correla-tion analysis also showed that the level of serum IL-17 was positively correlated with both low density lipoprotein cholesterol (LDL-c), hemoglobin A1c and systolic blood pressure(r=0. 162, 0. 255, 0. 152,respectively, P ＜0. 05). Logistic analysis showed that LDL-c, serum A-FABP and IL-17 were independent risk factors for LEAD. Conclusion The levels of A-FABP and IL-17 are increased significantly in patients with type 2 diabetes lower ex-tremity atherosclerotic disease, and closely related to the development of LEAD.