血清亲环素A对2型糖尿病患者合并大血管病变的影响及机制研究  

Effect and Mechanism of Serum Cyclophilin A on Macroangiopathy in Type 2 Diabetic Patients

作　　者：向莎[1,2] 吕肖锋[1,2] 曹怡[2] 张星光[2] 

机构地区：[1]安徽医科大学北京军区总医院临床学院,北京市100700 [2]北京军区总医院内分泌科

出　　处：《中国全科医学》2016年第13期1537-1541,共5页Chinese General Practice

摘　　要：目的了解血清亲环素A(CypA)对2型糖尿病(T2DM)患者合并大血管病变的影响,并探讨其可能机制。方法选取2014年11月—2015年6月在北京军区总医院就诊的T2DM患者60例,根据是否合并大血管病变分为大血管病变组(MCV组,n=30)和无大血管病变组(N-MCV组,n=30);另选取同时期在本院进行体检的健康成年人20例为对照组。收集3组受试者的一般资料,采用Pearson相关分析探讨CypA、核转录因子(NF-κB)、超敏C反应蛋白(hs-CRP)与其他一般资料的相关性,采用二分类Logistic回归分析探讨T2DM患者合并大血管病变的影响因素。结果 3组性别、平均年龄、BMI、收缩压及舒张压比较,差异无统计学意义(P>0.05);N-MCV组和MCV组平均病程比较,差异无统计学意义(P>0.05)。3组空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))、三酰甘油(TG)、CypA、NF-κB、hs-CRP比较,差异有统计学意义(P<0.05);总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)比较,差异无统计学意义(P>0.05)。Pearson相关分析结果显示,CypA与FPG、HbA_(1c)、NF-κB及hs-CRP呈线性正相关(P<0.05),NF-κB与FPG、HbA_(1c)、CypA及hs-CRP呈线性正相关(P<0.05),hs-CRP与FPG、HbA_(1c)、CypA及NF-κB呈线性正相关(P<0.05)。单因素分析结果显示,不同性别、年龄、病程、BMI、收缩压、舒张压、FPG、HbA_(1c)、TC、TG、LDL-C、HDL-C T2DM患者的大血管病变发生率比较,差异无统计学意义(P>0.05);而CypA、NF-κB、hs-CRP较高T2DM患者的大血管病变发生率较高,差异有统计学意义(P<0.05)。二分类Logistic回归分析结果显示,CypA对T2DM患者合并大血管病变的影响有统计学意义(P<0.05)。结论血清CypA可能通过扩大和引起氧化应激和炎性反应,参与T2DM患者大血管病变的发生发展,是连接糖尿病和动脉粥样硬化的重要因素,对糖尿病大血管病变具有一定的预测意义。Objective To investigate the effect of serum cyclophilin A（ CypA） on the pathogenesis of macroangiopathy in type 2 diabetes mellitus（ T2DM） patients and its possible mechanism. Methods From November 2014 to June 2015,we enrolled 60 T2 DM patients who received treatment in the General Hospital of Beijing Military Command. According to whether macroangiopathy occurs,the patients were divided into macroangiopathy group（ MCV group,n = 30） and non-macroangiopathy group（ N-MCV group, n = 30）. At the same time, we enrolled 20 healthy adults who received physical examination in the hospital as control group. General data of the three groups were collected. Pearson correlation analysis was conducted to investigate the correlation between CypA, NF-κB and hs-CRP and other general data. Binary Logistic regression analysis was undertaken to investigate the influencing factors for macroangiopathy in T2 DM patients. Results The three groups were not significantly different in gender,average age,BMI,systolic pressure and diastolic pressure（ P〉0. 05）; N-MCV group and MCV group were not significantly different in average length of disease（ P〉0. 05）. The three groups were not significantly different in TC,LDL-C and HDL-C（ P〉0. 05）,but were significantly different in FPG,HbA_（1c）,TG,CypA,NF-κ and hs-CRP（ P〈0. 05）. Pearson correlation analysis showed that CypA had linear positive correlation with FPG,HbA_（1c）,NF-κB and hs-CRP（ P〈0. 05）; NF-κB had linear positive correlation with FPG,HbA_（1c）,CypA and hs-CRP（ P〈0. 05）;hs-CRP had linear positive correlation with FPG,HbA_（1c）,CypA and NF-κB（ P〈0. 05）. Univariate analysis showed that T2 DM patients with different genders,ages,length of disease,BMI,systolic blood pressure,diastolic blood pressure,FPG,HbA_（1c）,TC,TG,LDL-C and HDL-C were not significantly different in the incidence rate of macroangiopathy（ P〉0. 05）; patients with higher CypA,NF-κB and hs-CRP had higher incidence of macroangiopathy（ P

关 键 词：亲环素A 糖尿病 2型 糖尿病血管病变 影响因素分析 机制探讨 

分 类 号：R587.1[医药卫生—内分泌]