血清成纤维细胞生长因子21、尿微量白蛋白与2型糖尿病下肢大血管病变的关系  

Relationships of FGF-21 and mAlb with lower extremity macroangiopathy in patients with type 2 diabetes mellitus

作　　者：刘畅[1] 宋娜[1] 王英南[1] 刘晓燕[1] 李桂芳[1] 金凤表[1] 高宇[1] LIU Chang;SONG Na;WANG Yingnan;LIU Xiaoyan;LI Guifang;JIN Fengbiao;GAO Yu(The Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《山东医药》2018年第33期13-16,共4页Shandong Medical Journal

基　　金：河北省医学科学研究重点课题计划(20160048)

摘　　要：目的探讨血清成纤维细胞生长因子21(FGF-21)、尿微量白蛋白(mAlb)与2型糖尿病患者下肢大血管病变的关系。方法选取2型糖尿病患者189例,根据是否合并下肢大血管病变将其分为病变组77例和无病变组112例,并选取50例体检健康者为对照组。分别采用酶联免疫吸附法、免疫比浊法测定三组血清FGF-21水平及尿液mAlb水平。采用Pearson积矩相关分析FGF-21、mAlb与血糖、血脂等指标的关系,多因素Logistic回归分析2型糖尿病患者下肢大血管病变的影响因素。结果三组糖化血红蛋白(HbA_(1c))、空腹血糖(FPG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、肌酐(Cr)、尿素氮(BUN)、同型半胱氨酸(Hey)、FGF-21、mAlb差异有统计学意义(P均<0.05)。与无病变组比较,病变组糖尿病病程长,HbA_(1c)、FPG、TC、LDL-C、Cr、BUN、Hey、FGF-21、mAlb水平高;与对照组比较,无病变组HbA_(1c)、FPG、Hey水平高;组间差异均有统计学意义(P均<0.05)。病变组血清FGF-21与糖尿病病程、HbA_(1c)、TC、Cr、Hey、mAlb呈正相关(P均<0.05);尿液mAlb与糖尿病病程、HbA_(1c)、TC、Cr、Hey、FGF-21呈正相关(P均<0.05)。糖尿病病程、FGF-21、mAlb是2型糖尿病患者下肢大血管病变的独立危险因素(P均<0.05)。结论 2型糖尿病患者血清FGF-21、尿液mAlb水平升高提示下肢大血管病变的发生风险增大。Objective To explore the relationships of fibroblast growth factor 21(FGF-21)and microalbuminuria(mAlb)with the lower extremity macroangiopathy in patients with type 2 diabetes mellitus(T2DM).Methods A total of 189 patients with T2DM were divided into the lesion group(n=77)and non-lesion group(n=112)according to whether they had lower extremity macroangiopathy.At the same time,50 healthy volunteers were randomly selected as the control group.The serum FGF-21 level was detected by enzyme-linked immunosorbent assay,and mAlb level was detected by the immunoturbidimetric assay.The correlations between FGF-21,mAlb level and blood sugar,blood fat were analyzed by Pearson moment correlation analysis.The relationships of FGF-21 and mAlb with the lower extremity macroangiopathy were analyzed by multivariate logistic regression analysis.Results Statistically significant differences in the HbA 1c,FPG,TC,LDL-C,Cr,BUN,Hey,FGF-21,and mAlb between the three groups were found(all P<0.05).The course of diabetes mellitus in the lesion group was longer,the levels of HbA 1c,FPG,TC,LDL-C,Cr,BUN,Hey,FGF-21 and mAlb were higher than those in the non-lesion group,the levels of HbAlc,FPG and Hey in the non-lesion group were higher than those in the control group,with statistically significant difference(all P<0.05).The serum FGF-21 in the lesion group was positively correlated with the course of diabetes mellitus,HbAlc,TC,Cr,Hey and mAlb(all P<0.05).The urine mAlb was positively correlated with the course of diabetes mellitus,HbAlc,TC,Cr,Hey,and FGF-21(all P<0.05).The course of diabetes mellitus,FGF-21,and mAlb were independent risk factors for lower extremity macroangiopathy in patients with T2DM(all P<0.05).Conclusion The elevated serum FGF-21 and urine mAlb level in T2DM patients suggests increased risk of lower extremity macroangiopathy.

关 键 词：2型糖尿病 下肢大血管病变 成纤维细胞生长因子21 尿微量白蛋白 

分 类 号：R587.1[医药卫生—内分泌]