老年2型糖尿病伴冠心病患者HDL-C与SAA、VCAM-1、ICAM-1、THP-1的相关性研究  

Relationship between the HDL-C and SAA, VCAM-1, ICAM-1, THP-1 in elderly patients with type 2 diabetes complicated coronary heart disease

作　　者：金勇[1] 王燕[1] 李艳 Jing Yong;Wang Yan;Li Yan(Department of Cardiology,the Second Hospital of Beijing,Beijing 100031,China.;Department of General Medicine,the Second Hospital of Beijing,Beijing 100031,China.)

机构地区：[1]北京市第二医院心内科,北京100031 [2]北京市第二医院综合内科,北京100031

出　　处：《贵州医药》2020年第2期178-181,共4页Guizhou Medical Journal

摘　　要：目的探讨老年2型糖尿病(T2DM)伴冠心病(CHD)患者高密度脂蛋白胆固醇(HDL-C)与血清淀粉样蛋白酶A(SAA)、血管细胞粘附分子1(VCAM-1)、细胞间粘附分子1(ICAM-1)及人单核细胞THP-1表达的相关性。方法选取老年T2DM患者(T2DM组)、CHD患者(CHD组)、T2DM伴CHD患者(T2MD+CHD组)及健康老年人(NC组)各32例。统计各组一般临床特征、糖脂代谢指标,检测HDL中SAA、VCAM-1、ICAM-1、THP-1、超敏C反应蛋白(hs-CPR)、白介素-6(IL-6)、单核细胞趋化蛋白-1(MCP-1)水平。结果 T2DM组、CHD组、T2DM+CHD组的HDL-C均显著低于NC组(P<0.05);T2DM组、CHD组、T2DM+CHD组的HDL中SAA、VCAM-1、ICAM-1、THP-1、hs-CPR、IL-6、MCP-1均显著高于NC组,且T2DM+CHD组高于其余两组(P<0.05)。HDL-C仅在T2MD组和T2DM+CHD组中与hs-CRP显著负相关(P<0.05);在T2DM组、CHD组、T2DM+CHD组中,SAA与VCAM-1、ICAM-1、THP-1、hs-CPR、IL-6、MCP-1均呈显著正相关(P<0.05)。结论老年T2DM和CHD患者均具有HDL功能受损,且在T2MD伴CHD时HDL功能下降更为明显,SAA水平越高则VCAM-1、ICAM-1及炎性细胞因子水平越高,HDL抗炎能力、抗黏附及血管保护效应越弱。Objective To investigate the relationship between high density lipoprotein cholesterol(HDL-C) and its related serum amyloid A(SAA),vascular cell adhesion molecule 1(VCAM-1), intercellular adhesion molecule 1(ICAM-1) and human monocyte THP-1 expression in elderly patients with type 2 diabetes mellitus(T2 DM) complicated coronary heart disease(CHD). Methods Elderly patients with T2 DM(T2 DM group), CHD(CHD group), T2 DM with CHD(T2 MD+CHD group) and healthy elderly(NC group) were enrolled, each group with 32 cases. The general clinical characteristics, glucose and lipid metabolism indexes of each group were analyzed, the levels of HDL related SAA, VCAM-1, ICAM-1, THP-1, high-sensitivity C-reactive protein(hs-CPR), interleukin-6(IL-6), monocyte chemoattractant protein-1(MCP-1) were detected. Results The HDL-C of T2 DM group, CHD group and T2 DM+CHD group were significantly lower than those of NC group(P<0.05). HDL related SAA and plasma VCAM-1, ICAM-1, THP-1, hs-CPR, IL-6 and MCP-1 of T2 DM group, CHD group and T2 DM+CHD group were significantly higher than those in the NC group, and the T2 DM+CHD group was higher than the other two groups(P<0.05). HDL-C was significantly negatively correlated with hs-CRP only in the T2 MD group and the T2 DM+CHD group(P<0.05). There was significant positive correlation between SAA and VCAM-1, ICAM-1, THP-1, hs-CPR, IL-6 and MCP-1 in the T2 DM group, CHD group, T2 DM+CHD group(P<0.05). Conclusion Elderly patients with T2 DM and CHD have impaired HDL function, and damage of HDL function is more obvious when T2 MD complicated CHD. The higher the level of SAA, the higher the levels of VCAM-1, ICAM-1 and inflammatory cytokines, and the weaker the anti-inflammatory, anti-adhesion and vascular protective effects of HDL.

关 键 词：2型糖尿病 冠心病 高密度脂蛋白 血清淀粉样蛋白酶A 血管细胞粘附分子1 细胞间粘附分子1 炎症因子 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]