2型糖尿病患者颈动脉粥样硬化与血清亚临床炎性因子的相关研究

目的观察2型糖尿病（T2DM）患者血清慢性亚临床炎症因子与颈动脉粥样硬化（AS）的关系,探讨炎性反应对糖尿病大血管病变的影响。方法检测新乡医学院第一附属医院136例T2DM患者双侧颈总动脉内中膜厚度（IMT）,根据超声检查结果,分为对照组（C组,85例）和颈AS组（A组,51例）,比较两组体重指数（BMI）、空腹血糖（FBG）、空腹胰岛素（FINS）、外周血白细胞计数（WBC）、超敏C反应蛋白（hs-CRP）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、三酰甘油（TG）、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）。结果 A组与C组比较,BMI、WBC、hs-CRP、LDL-C、TG、HbA1c、HOMA-IR均升高,且差异均有统计学意义（P〈0.05或P〈0.01）。相关分析显示,IMT与BMI、WBC、hs-CRP、LDL-C、TG、HbA1c、HOMA-IR呈正相关（r分别为0.21、0.26、0.63、0.42、0.32、0.05、0.17、0.31,P值分别为0.01、0.16、0.52、0.00、0.00、0.00、0.00、0.02）。结论慢性亚临床炎症参与T2DM大血管病变的发生及发展,血清炎性因子水平可以在一定程度上反映糖尿病患者的颈AS程度,为预测和评估病情提供依据。

Relationship between carotid atherosclerosis and subclinical inflammatory factors in type 2 diabetic patients

Objective To observe the association between chronic subclinical inflammatory factors and carotid atheroselerosis （AS） in patients with type 2 diabetes mellitus （T2DM）. Methods 136 T2DM patients in First Hospital Affiliated to Xinxiang Medical College were measured with their bilateral carotid intima media thickness （IMT）. According to the result of ultrasonic examination, all patients were divided into control group （group C, n = 85） and AS group （group A, n = 51）. The index of body mass index （BMI）, fasting plasma glucose （FBG）, fasting plasma insulin （FINS）, white blood count （WBC） of peripheral blood, high sensitivity C-reaction protein （hs-CRP）, low density lipoprotein （LDL-C）, total cholesterol （TC）, triglyceride （TG）, hemoglobin （HbA1c）, and insulin resistance index （HOMA-IR） were compared between the two groups. Results Compared with group C, BMI, WBC, hs-CRP, LDL-C, TG, HbA1c, HOMA-IR in group A increased, and there were significant differences between them （P 〈 0.05 or P 〈 0.01）. Moreover, correlation analysis showed that IMF was positively related with BMI, WBC, hs-CRP, LDL-C, TG, HbA1c, HOMA-IR （r values were 0.21, 0.26, 0.63, 0.42, 0.32, 0.05, 0.17, 0.31 respectively, while P values were 0.01, 0.16, 0.52, 0.00, 0.00, 0.00, 0.00, 0.02）. Conclusion Chronic subclinical inflammation may be involved in the occurrence and development of macroangiopathy in T2DM. The level of serum inflammatory factors in a certain extent reflects the diabetes patients with carotid atherosclerosis degree, it also provides prediction and assessment for the state of the disease.