缺血修饰白蛋白与2型糖尿病心血管疾病关系研究

目的 研究2型糖尿病（T2DM）患者缺血修饰白蛋白（IMA）与临床心血管疾病（CVD）的关系.方法 采用回顾性研究,选取T2DM患者96例（T2DM组）,并选择60例健康体检者作为对照组.收集患者的病史资料,检测IMA并行心脏彩超检查.对IMA与相关参数进行分析.结果 96例T2DM患者中28例（29.2％,28/96）出现CVD.T2DM组IMA水平为（58.25±11.84） kU/L,其中T2DM合并CVD组（28例）和T2DM非合并CVD组（68例）的IMA水平分别为（91.46±13.63）,（47.91±9.38） kU/L;对照组IMA水平为（23.38±6.41） kU/L.T2DM组IMA水平高于对照组,并且T2DM合并CVD组IMA水平高于T2DM非合并CVD组和对照组,差异均有统计学意义（P＜0.05）.所有T2DM患者均完成心脏彩超检查,将IMA与心脏彩超指标进行Spearman相关分析,结果显示,IMA水平与左室舒张末期内径（r=0.546,P=0.031）、室间隔厚度（r=0.427,P=0.039）、左室后壁厚度（r=0.582,P=0.026）、左室质量指数（r=0.339,P=0.042）呈正相关;与左室射血分数（r=-0.561,P=0.024）呈负相关.多因素Logistic回归分析显示,IMA、超敏C反应蛋白、糖尿病病程、空腹血糖是T2DM患者合并CVD的独立危险因素.结论 T2DM患者IMA水平较高,IMA水平升高是CVD的相关危险因素.

The relationship between ischemia modified albumin and cardiovascular diseases in patients with type 2 diabetes mellitus

Objective To study the relationship between cardiovascular diseases （CVD） and ischemia modified albumin （IMA） in patients with type 2 diabetes mellitus （T2DM）.Methods Ninety-six patients with T2DM were selected as T2DM group retrospectively,and 60 cases of healthy physical examination were selected as control group,the patient＇ s medical history data were collected,the IMA was detected and Doppler ultrasound examination was performed.The relationship between serum IMA level and some laboratory parameters were analyzed.Results Twenty-eight cases （29.2%,28/96） occurred CVD among 96 cases of T2DM patients.The level of IMA in T2DM group was higher than that in control group [（58.25 ± 11.84） kU/L vs.（23.38 ± 6.41） kU/L],there was significant difference （P 〈 0.05）.The levels of IMA in T2DM combined with CVD group （28 cases） and T2DM not combined with CVD group （68 cases） were（91.46 ± 13.63）,（47.91 ± 9.38） kU/L; the level of IMA in T2DM combined with CVD group was higher than that in T2DM not combined with CVD group and control group,there was significant difference （P 〈 0.05）.All patients completed echocardiography,Spearman correlation analysis between IMA and echocardiography indicators showed that the level of IMA was positively correlated with left ventricular end-diastolic diameter （r =0.546,P =0.031）,interventricular septal thickness （r =0.427,P =0.039）,posterior wall diameter of left ventricle at end-diastolic （r =0.582,P =0.026） and left venifieular mass index （r =0.339,P =0.042）,and IMA was negatively correlated with ejection fraction of left ventricle （r =-0.561,P =0.024）.Multivariable Logistic regression analysis showed that IMA,high-sensitivity C reactive protein,diabetes duration,fasting blood glucose levels were independent risk factors for CVD.Conclusions Serum IMA level is significantly higher in T2DM patients.IMA level is a related risk factor for CVD.