老年2型糖尿病患者血清内脂素水平与外周动脉疾病及炎症因子的关系  

Relationship of serum visfatin level with peripheral arterial disease and inflammatory factor in senile type 2 diabetic patients

作　　者：蒋蓝英[1] 郦旦明[1] 何炳荣[1] 付仲颖[1] 

机构地区：[1]浙江中医药大学附属中西医结合医院老年病科,杭州310003

出　　处：《浙江医学》2013年第6期421-423,443,共4页Zhejiang Medical Journal

摘　　要：目的探讨血清内脂素在2型糖尿病(T2DM)合并外周动脉疾病老年患者中的变化,评价血清内脂素水平与外周动脉疾病及炎症因子的关系。方法按彩色多普勒超声检查外周动脉结果分为T2DM合并外周动脉疾病组(T2DM-PAD组)52例、T2DM无外周动脉疾病组(T2DM组)50例和对照组45例,测量血压、BMI、腰围(WC)、WHR及检测FPG、空腹胰岛素、血脂、HbA1c、纤维蛋白原等代谢指标,并计算稳态模型胰岛素抵抗指数(HOMA-IR);测定所有受试者hs-CRP、IL-6、TNF-α和内脂素水平。结果(1)T2DM-PAD组和T2DM组hs-CRP、纤维蛋白原、IL-6、TNF-α和内脂素显著高于对照组(P<0.05或0.01),T2DM-PAD组hs-CRP、IL-6、TNF-α和内脂素明显高于T2DM组(均P<0.05);(2)Pearson相关分析结果显示,T2DM-PAD组和T2DM组血清内脂素与hs-CRP、纤维蛋白原、IL-6、TNF-α、颈动脉内膜中层厚度(C-IMT)、WC、FPG、空腹胰岛素、HOMA-IR、HbA1c均呈正相关(均P<0.05或0.01);(3)多元逐步回归分析,T2DM-PAD组和T2DM组WC、HOMA-IR、HbA1c、hs-CRP、IL-6、TNF-α为影响老年T2DM患者血清内脂素的独立相关因素(P<0.05或0.01)。结论血清内脂素可能在T2DM外周动脉疾病发生和发展过程中起一定作用,与炎症因子联系密切,且独立于脂质代谢紊乱所起的作用。Objective To investigate serum visfatin level and its relationship with peripheral arterial disease （PAD） and inflammatory factors in senile type 2 diabetic（T2DM） patients. Methods Fifty two elderly patients（〉60y） with T2DM-PAD and 50 elderly patients with T2DM without PAD and 45 healthy controls were enrolled in the study. Blood pressure, body mass index （BMI）, waist circumference （WC）, weight/height ratio （WHR）, fasting plasm glucose （FPG）, fasting insulin, blood lipid analysis, HbAIc and fibrinogen were determined. Serum hs-CRP, IL-6, TNF-α and visfatin were examined by ELISA. Results In T2DM-PAD and T2DM patients serum hs-CRP, fibrinogen, IL-6, TNF-α and visfatin were higher than those in control group （P〈0.05 or P〈0.01）. Serum hs-CRP, IL-6, TNF- α and visfatin were higher in T2DM-PAD group than those in T2DM group （P〈 0.05 or P〈0.01）. Pearson＇s correlation analysis demonstrated that serum visfatin level was positively correlated with hs-CRP, fibrinogen, IL-6, TNF-α, C-IMT, WC, FPG, fasting insulin, HOMA-IR and HbAlc. Multiple regression analysis showed that WC, HOMA-IR, HbAlc, hs-CRP, IL-6, TNF-α was the independent related factor of influencing serum visfatin level. Conclusion Visfatin may be involved in the occurrence and development of peripheral arterial diseases in patients with type 2 diabetes mellitus. which is correlate with inflammatorv factors, independent to lioid disorder.

关 键 词：炎症因子 内脂素 2型糖尿病 外周动脉疾病 老年 

分 类 号：R587.1[医药卫生—内分泌]