初诊2型糖尿病患者血清PAI-1、NO、3-NT与FMD的相关性研究  

Study on the Correlation between Serum PAI-1,NO,3-NT and FMD in Newly Diagnosed Type 2 Diabetic Patients

作　　者：唐芳[1] 蒋铁建[2] TANG Fang;JIANG Tiejian(Department of Endocrinology,Shenzhen Third People's Hospital,Shenzhen,Guangdong Province,518000 China;Department of Endocrinology,Xiangya Hospital,Central South University,Changsha,Hunan Province,410008 China)

机构地区：[1]深圳市第三人民医院内分泌科,广东深圳518000 [2]中南大学湘雅医院内分泌科,湖南长沙410008

出　　处：《糖尿病新世界》2021年第6期60-63,共4页Diabetes New World Magazine

摘　　要：目的探讨初诊2型糖尿病患者血清纤溶酶原激活物抑制剂1(PAI-1)、一氧化氮(NO)和3-硝基酪氨酸(3-NT)水平的变化及其与肱动脉血流介导的内皮依赖性血管舒张功能(FMD)之间的关系,探讨血管内皮功能障碍的危险及保护因素。方法选取2012年7月—2013年3月收治的初诊T2DM患者144例,其中从未接受过降糖治疗的初诊的T2DM患者作为观察组,选取72名性别及年龄相匹配的健康体检者作为对照组,用ELISA法检测血清PAI-1、NO和3-NT,采用高分辨超声技术分别检测FMD。结果①两组对象在年龄、性别、BMI方面差异无统计学意义(P>0.05)。观察组MAP、TC、TG、FPG、HbA1c、HOMA-IR高于对照组,差异有统计学意义(P<0.05);观察组HOMA-β低于对照组,差异有统计学意义(P<0.05)。②与对照组比较,观察组PAI-1、3-NT明显增高,NO、FMD明显降低,差异有统计学意义(P<0.05)。③相关分析显示,观察组血清PAI-1、3-NT与FMD呈负相关;而NO与FMD呈正相关。④多元回归分析显示,NO是血管内皮功能的保护因素,而PAI-1、MAP是血管内皮功能的危险因素。结论初诊T2DM患者存在明显的纤溶异常、氧化硝化反应和血管内皮依赖性血管舒张功能障碍,在糖尿病早期治疗中关注改善纤溶异常和减轻氧化硝化反应在一定程度上可保护血管内皮功能,延缓糖尿病血管并发症的发生发展。Objective To investigate the changes of serum plasminogen activator inhibitor 1(PAI-1),nitric oxide(NO)and 3-nitrotyrosine(3-NT)levels in newly diagnosed type 2 diabetic patients and the relationship between it and the endothelium-dependent vasodilation function(FMD)mediated by brachial artery blood flow,to explore the risk and protective factors of vascular endothelial dysfunction.Methods A total of 144 newly diagnosed T2DM patients admitted from July 2012 to March 2013 were selected.Among them,newly diagnosed T2DM patients who had never received hypoglycemic therapy were selected as the observation group,and 72 gender and age matching healthy subjects served as the control group.Serum PAI-1,NO and 3-NT were detected by ELISA,and FMD was detected by high-resolution ultrasound technology.Results 1.There was no statistically significant difference in age,gender and BMI between the two groups of subjects(P>0.05).The observation group MAP,TC,TG,FPG,HbA1c,HOMA-IR were higher than the control group,the difference was statistically significant(P<0.05);the observation group HOMA-βwas lower than the control group,the difference was statistically significant(P<0.05).2.Compared with the control group,PAI-1 and 3-NT in the observation group were significantly increased,while NO and FMD were significantly decreased in the observation group.The differences were statistically significant(P<0.05).3.Correlation analysis showed that serum PAI-1 and 3-NT of the observation group were negatively correlated with FMD;while NO was positively correlated with FMD.4.Multiple regression analysis showed that NO was a protective factor for vascular endothelial function,while PAI-1 and MAP were risk factors for vascular endothelial function.Conclusion Patients with newly diagnosed T2DM have obvious fibrinolytic abnormalities,oxidative nitrification reactions,and vascular endothelial-dependent vasodilation dysfunction.In the early treatment of diabetes,improving fibrinolytic abnormalities and reducing oxidative nitrification reactions can pr

关 键 词：2型糖尿病 纤溶酶原激活物抑制剂1 一氧化氮 3-硝基酪氨酸 血管内皮功能 

分 类 号：R587.2[医药卫生—内分泌]