血清YKL-40水平与2型糖尿病患者冠状动脉病变程度的相关性

目的探讨血清YKL-40水平与2型糖尿病患者冠状动脉病变程度的关系。方法选择因心绞痛行冠状动脉造影的2型糖尿病患者197例,根据造影结果,冠状动脉正常为对照组(n=89),冠状动脉病变为冠心病组(n=108)。根据冠状动脉病变支数分为单支病变、双支病变和三支病变;Gensini积分评价冠状动脉病变狭窄程度。ELISA测定血清YKL-40和高敏C反应蛋白水平(hs-CRP)。结果冠心病组和对照组间血清YKL-40、hs-CRP、收缩压、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、脂蛋白(a)、餐后2 h血糖、糖化血红蛋白水平及吸烟率存在明显的差异(P<0.05)。不同冠状动脉病变支数组血清YKL-40水平和Gensini积分存在显著差异(P<0.01);血清YKL-40与Gensini积分存在明显相关性(r=0.611,P<0.01)。Logistic回归分析显示,血清YKL-40是2型糖尿病患者罹患冠心病的危险因素(OR=1.229,95%CI为1.086～1.427,P=0.003)。结论 YKL-40可能参与2型糖尿病粥样硬化的发生发展过程,血清YKL-40水平与2型糖尿病患者冠状动脉病变的严重性相关。

Association Between Serum YKL-40 Level and Degree of Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus

Aim To investigate the association between serum YKL-40 and degree of coronary artery disease(CAD) in patients with type 2 diabetes mellitus.Methods 197 patients with type 2 diabetes mellitus undergoing coronary angiography because of angina-like symptoms were divided into control group(n=89) and CAD group(n=108) according to the absence or presence of significant coronary stenosis(luminal diameter narrowing of ≥50%).The degree of CAD was graded as single-,double-or three-vessel disease,and Gensini score was used to evaluate the extent of CAD.Serum YKL-40 and high sensitivity C-reactive protein(hs-CRP) levels were assessed by ELISA.Results Compared with control group,CAD patients were more cigarette smoker and had higher systolic blood pressure and serum levels of total cholesterol(TC),low density lipoprotein cholesterol(LDLC),apolipoprotein B(ApoB),lipoprotein(a)(Lp(a)),2 h postprandial blood glucose(2h BG),HbA1c,YKL-40,and hs-CRP(all P<0.05).Serum YKL-40 level was increased in patients with CAD,which was more remarkable in those with two-or three-vessel disease(P<0.01),and the Gensini score of single-vessel disease was lower than that of two-disease and three-disease vessel(P<0.01).Furthermore,significant correlation between serum YKL-40 and Gensini score was observed(r=0.611,P<0.01).Multivariate Logistic regression analysis indicated that serum YKL-40 was a risk factor for CAD in patents with 2 diabtetes mellitus(OR=1.229,95%CI was 1.086~1.427,P=0.003).Conclusions YKL-40 may be involved in the initiation and development of atherosclerosis in diabetic patients,and serum YKL-40 level is associated with the severity of CAD in patients with type 2 diabetes mellitus.