2型糖尿病下肢血管病变与脂联素及高敏C-反应蛋白关系的研究

目的观察单纯2型糖尿病(T2DM)和T2DM并下肢血管病变患者血浆脂联素及高敏C-反应蛋白(HsCRP)的变化,探讨其在糖尿病及下肢血管病变发生发展中的影响。方法入选研究对象115例,为2004年12月至2005年6月在内蒙古医学院第一附属医院内分泌科住院患者及门诊健康体检者。正常对照组30名;T2DM组85例,其中单纯T2DM组42例,并下肢血管病变组43例。用酶联免疫吸附试验(ELISA)法检测血浆脂联素,用散射比浊法检测HsCRP。结果正常对照组血浆脂联素高于T2DM组,单纯T2DM组高于并下肢血管病变组,组间比较差异有显著性意义(P<0.05);HsCRP水平则相反,差异也有显著性意义(P<0.05)。单因素相关分析显示脂联素与高密度脂蛋白胆固醇(HDL-C)呈正相关,与低密度脂蛋白胆固醇(LDL-C)、体重指数(BMI)、空腹血糖(FPG)呈负相关;HsCRP与LDL-C、BMI呈正相关,与HDL-C呈负相关;脂联素和HsCRP均与年龄、胰岛素抵抗指数(HOMA-IR)无相关;脂联素与HsCRP呈强负相关。结论脂联素、HsCRP与糖尿病及下肢血管病变的发生及发展相关。脂联素、HsCRP可作为早期诊断糖尿病下肢血管病变及预测其预后的参考指标。

Relationship between plasma concentrations of adiponectin and high sensitive C reactive protein in diabetes with lower extremities vascular disease

Objective To observe plasma concentration of adiponectin and high sensitive C reactive protein (HsCRP) in Type 2 diabetes mellitus(T2DM) with/without lower extremities vascular disease,and explore the influences of adiponectin and HsCRP in the genesis and development of them.Methods We selected 115 subjects in our hospital and divided them into 2 groups:normal control group and T2DM group,including simple T2DM and T2DM with diabetic lower extremities vascular disease;in addition,we measured plasma adiponectin and HsCRP with ELISA and scattered radiation turbidimetry for them.Results Plasma adiponectin concentration in the comparing group was higher than T2DM,and the level in simple T2DM patients was higher than the one with lower extremities vascular disease,showing an obviously decreased tendency,and significant differences were detected in plasma adiponectin concentration between groups (P<0.01).However,HsCRP showed a contrary tendency and the differences were also significant (P<0.01).Correlation analysis showed:plasma adiponectin concentration was negatively correlated with LDL-C,BMI,FPG and HsCRP.In addition,it was positively correlated with HDL-C.HsCRP was positively correlated with LDL-C and BMI and negatively correlated with HDL-C.Both adiponectin and HsCRP were not correlated with age,TG and HOMA-IR.Conclusion There may be relations between plasma concentrations of adiponectin and HsCRP and the occurrence of T2DM and diabetic lower extremities vascular disease.Adiponectin and HsCRP can be taken as the indexes for early diagnosis and prediction of prognosis in the patients of diabetic lower extrensities vascular disease.