血管生成素样蛋白2与2型糖尿病下肢动脉病变的关系  

Assosiation of angiopoietin-like protein 2 to lower extremity arterial disease in type 2 diabetes mellitus

作　　者：宋娓[1] 张鲲[2] 路巍[1] 董利平[1] 栾健[1] 李长贵[3] 

机构地区：[1]青岛大学附属青岛市市立医院内分泌科,266011 [2]青岛大学附属青岛市市立医院血管外科,266011 [3]青岛大学附属医院代谢病科,山东省痛风病临床医学中心,山东省代谢性疾病重点实验室,266003

出　　处：《中华内分泌代谢杂志》2015年第10期872-876,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的研究血管生成素样蛋白2（ANGPTL2）与2型糖尿病下肢动脉病变的关系。方法筛选360例2型糖尿病患者，按照踝肱指数（ABI）分为单纯2型糖尿病组（A组）、2型糖尿病伴轻中度下肢动脉病变组（B组）、2型糖尿病伴重度下肢动脉病变组（C组）及120例健康体检者作为对照（NC组）。检测血清ANGPTL2、超敏C反应蛋白（hsCRP）、游离脂肪酸、生化指标、HbA。空腹胰岛素并计算腰臀比、体重指数、胰岛素抵抗指数。结果随着下肢动脉病变程度的加重，ANGPTL2水平逐渐升高，轻中度下肢动脉病变组明显高于单纯2型糖尿病组[1．27（1．09，1．51）对0．88（0．66，1．07）μg／L，P〈0．05]，重度下肢动脉病变组明显高于轻中度病变组[1．70（1．45，1．91）对1．27（1．09，1．51）μg／L，P〈0．05]。Pearson相关分析显示hsCRP、体重指数、腰臀比、总胆固醇、低密度脂蛋白胆固醇、空腹胰岛素、胰岛素抵抗指数与血清ANGPTL2呈正相关。Logistic回归分析显示ANGPTL2、hsCRP、HbA1C与2型糖尿病下肢动脉病变显著相关（P〈0．05）。结论ANGPTL2可能是2型糖尿病下肢动脉病变的危险因素之一，ANGPTL2的检测可能对2型糖尿病下肢动脉病变的早期预测、病情判断和预后评估均有重要意义。Objective To study the assosiation of angiopoietin-like protein 2 （ANGPTL2） to lower extremity arterial disease in type 2 diabetes mellitus. Methods A total of 360 type 2 diabetic patients were divided into three groups ： without （ group A）, with mild to moderate （ group B）, and severe （ group C ） lower extremity arterial disease according to the ankle brachial index. And, 120 healthy subjects serveed as control group. The levels of ANGPTL2, high sensitivity C-reactive protein （hsCRP）, free fatty acid, biochemical index, and fasting insulin were detected. And, waist-to-hip ratio （WHR）, body mass index （BMI）, insulin resistance index were calculated. Results The level of ANGPTL2 was getting higher and higher as lower extremity arterial disease progressing. The level of ANGPTL2 in group B was higher than that in group A [ 1.27 （ 1.09,1.51 ） vs O. 88 （ 0.66,1.07 ） μg/L, P〈 0.05 ], and the level of ANGPTI2 in group C was higher than that in group B [ 1.70 （ 1.45,1.91 ） vs 1.27 （ 1.09, 1.51 ） μg/L, P〈0.05 ]. Pearson correlation analysis showed that the ANGPTL2 level in serum positively correlated with hsCRP, BMI, WHR, cholesterol, low-density lipoprotein-cholesterol, fasting insulin, and insulin resistance index. Logistic regression analysis showed that the levels of ANGPTL2, hsCRP, and glycosylated hemoglobin were significantly associated with lower extremity arterial disease in type 2 diabetes mellitus. Conclusion It is possible that ANGPTL2 is one of the risk factors of lower extremity arterial disease in type 2 diabetes mellitus, and which is likely to be of great significance in the early prediction, disease assessment, and prognosis evaluation for lower extremity arterial disease in type 2 diabetes mellitus.

关 键 词：血管生成素样蛋白2 糖尿病 2型 下肢动脉病变 

分 类 号：R587.2[医药卫生—内分泌]