新诊2型糖尿病患者血小板反应蛋白-1水平变化及其与发病机制的关系  

Changes in level of thrombospondins-1 in patients newly diagnosed with type 2 diabetes mellitus and its relationship with pathogenesis

作　　者：边志颖[1] 孙倩[1] 胡艳云[1] 王君[1] 郄海静 尹超[1] 赵新翠 BIAN Zhiying;SUN Qian;HU Yanyun;WANG Jun;QIE Haijing;YIN Chao;ZHAO Xincui(Department of Endocrinology,the First Central Hospital of Baoding,Baoding,HeBei 071000,China)

机构地区：[1]河北省保定市第一中心医院内分泌三科,071000

出　　处：《重庆医学》2018年第18期2418-2420,2423,共4页Chongqing medicine

基　　金：河北省2016年度医学科学研究重点课题计划(20160006)

摘　　要：目的探讨新诊断2型糖尿病(T2DM)患者血清血小板反应蛋白-1(TSP-1)水平变化及其与胰岛素抵抗的关系。方法选取2016年6-9月于该院就诊的新发T2DM患者51例(A组),以及同期门诊体检健康者49例(B组)。监测并比较两组血清TSP-1、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、纤维蛋白原(FIB)、血压、体质量指数(BMI)等指标,计算胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β),分析T2DM患者血清TSP-1水平与其他各项指标的相关性。结果 A组患者血清TSP-1水平高于B组,差异有统计学意义(P<0.01)。相关分析显示,TSP-1与FPG、FINs、HbA1c、HOMA-IR、LDL-C、FIB呈正相关(r=0.691,P=0.000;r=0.233,P=0.020;r=0.771,P=0.000;r=0.605,P=0.000;r=0.293,P=0.017;r=0.412,P=0.000),与HOMA-β呈负相关(r=-0.748,P=0.000)。Logistics多元线性逐步回归分析显示,HbA1c、FINS、HOMA-β、FIB、FPG是血清TSP-1的独立影响因素(回归系数分别为0.614、0.211、-0.461、0.200、-0.317,P<0.01或P<0.05)。结论新诊断T2DM患者血清TSP-1水平明显升高,且TSP-1水平与胰岛素抵抗有关。Objective To investigate changes in serum thrombospondin-1（TSP-1）level and its relationship with insulin resistance in patients newly diagnosed with type 2 diabetes mellitus（T2 DM）.MethodsA total of 51 cases of patients newly diagnosed with T2 DM（group A）and 49 healthy individuals undergoing physical examination（group B）in the hospital from June to September 2016 were collected.Indicators,including serum TSP-1,fasting plasma glucose（FPG）,fasting insulin（FINS）,glycated hemoglobin（HbA1 c）,cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,fibrinogen（FIB）,blood pressure,body mass index（BMI）,insulin resistance index（HOMA-IR）and isletβcell function index（HOMA-β）were monitored and compared between the two groups.And the correlations of TSP-1 with the other indicators were analysed.Results The serum level of TSP-1 in the group A was higher than that in the group,the difference was statistically significant（P〈0.01）.The correlation analysis showed that serum level of TSP-1 was positively correlated with levels of FPG,FINs and HbA1 c,HOMA-IR value,levels of LDL-C and FIB（r=0.691,P=0.000;r=0.233,P=0.020;r=0.771,P=0.000;r=0.605,P=0.000;r=0.293,P=0.017;r=0.412,P=0.000）,and negatively correlated with HOMA-βvalue（r=-0.748,P=0.000）.Stepwise multiple logistics regression analysis showed that HbA1 c,FINS,HOMA-β,Fib and FPG were independent factors of serum TSP-1（regression coefficients were 0.614,0.211,-0.461,0.200,-0.317,P〈0.01 or P〈0.05）.Conclusion The serum level of TSP-1 is significantly increased in patients newly diagnosed with T2 DM,and the TSP-1 level is associated with insulin resistance.

关 键 词：糖尿病 2型 血小板反应蛋白-1 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]