血清对氧磷酶1活性与2型糖尿病患者颈动脉粥样硬化的关系  

Correlation of serum paraoxonase 1 activity with carotid atherosclerosis in patients with type 2 diabetes mellitus

作　　者：张亮[1] 陈启稚[1] 王长谦[1] 程纯[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院心内科,上海200011

出　　处：《临床荟萃》2015年第3期257-261,共5页Clinical Focus

基　　金：国家自然科学基金资助项目(81300087)

摘　　要：目的探讨血清对氧磷酶1(paraoxonase 1,PON1)活性与2型糖尿病患者颈动脉粥样硬化的关系。方法2型糖尿病患者117例,根据颈动脉彩色多普勒超声测定结果,分为无动脉粥样硬化(AS)组38例,AS组79例;选择同期健康体检者75例(对照组),测量血压、体质量指数(BMI)、腰臀比、空腹血糖、餐后2小时血糖、糖化血红蛋白、总胆固醇、甘油三酯(TG)、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸等各项指标,同时测定血清PON1活性。分析血清PON1活性与颈动脉粥样硬化的关系。结果与对照组比较,糖尿病组血清PON1(240.0±15.6)kU/L vs(229.5±19.6)kU/L、AS发生率(44.0%vs 67.5%)、BMI(24.3±3.6)kg/m2 vs(25.8±3.2)kg/m2、腰臀比(0.89±0.05)vs(0.93±0.06)、收缩压(131.0±8.3)mmHg(1mmHg=0.133kPa)vs(134.0±8.8)mmHg、TG(1.8±0.8)mmol/L vs(2.1±1.3)mmol/L等比较差异有统计学意义(P<0.05);AS组血清PON1活性明显低于非AS组(235.5±19.9)kU/L vs(226.7±18.9)kU/L(P<0.05);糖尿病患者血清PON1活性与年龄呈负相关(r=-0.382,P<0.01),与血清TG水平呈正相关(r=0.223,P<0.05)。结论 2型糖尿病患者血清PON1活性显著下降,PON1活性降低与颈动脉粥样硬化发生密切相关。Objective To explore the correlation of serum paraoxonase 1 （PON1） activity with the incidence of carotid atherosclerosis（AS） in patients with type 2 diabetes mellitus（T2DM）. Methods A total of 117 patients with T2DM, including 38 cases with carotid atherosclerosis and 79 cases without carotid atherosclerosis, were enrolled in this study. Also, 75 healthy individuals without diabetes served as control group. Blood pressure, body mass index （BMI）, waist-hip ratio, fasting blood glucose, 2-hour post-meal blood glucose, HbAlc, total cholesterol, triglyceride （TG）, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, uric acid and serum PON1 activity of two groups were determined and compared. Then,the relationship between the serum PON1 activity and the incidence of carotid atherosclerosis were analyzed. Results Serum PON1 activity in T2DM group was lower than that in control group （229.5-＋19.6 kU/L vs 240.0=[=15.6 kU/L, P dO. 05）. The incidence of carotid atherosclerosis, BMI, waisthip ratio, systolic pressure and TG in T2DM group were prominently higher than those in control group, respectively 67.5% vs 44.0% ,25.8±3.2 kg/mz vs 24.3±3.6 kg/mz ,0.93±0.06 vs 0. 89±0. 05,134. 0±8. 8 mmHg vs 131.0±8.3 mmHg and 2. I：L1.3 mmol/L vs 1.8±0.8 mmol/L（ P d0.05）. Among the patients with T2DM, serum PON1 activity in AS group was significantly lower than that in non-AS group （226.7±18.9 kU/L vs 235.5 ±19.9 kU/L, P 0, 05）. Serum PON1 activity was negatively correlated with the age of the patients （ r =-0. 382, P〈0.01）, but positively correlated with TG （ r = 0. 223, P 〈0.05）. Conclusion Serum PON1 activity decreases significantly in patients with T2DM,which is closely associated with the incidence of carotid atherosclerosis.

关 键 词：糖尿病 2型 动脉粥样硬化 对氧磷酶1 

分 类 号：R587.1[医药卫生—内分泌]