血清IGF-1、IGFBP-3水平与2型糖尿病患者糖脂代谢紊乱及颈动脉斑块不稳定性的关系研究  

Study on the Relationship between Serum IGF-1,IGFBP-3 Levels and Glucose and Lipid Metabolism Disorders and Carotid Plaque Instability in Patients with Type 2 Diabetes Mellitus

作　　者：童慧玲 卞家骏 詹秋月 TONG Hui-ling;BIAN Jia-jun;ZHAN Qiu-yue(Department of General Medicine,Shaxian District General Hospital of Sanming,Sanming,Fujian,365500,China;Department of Internal Medicine,Shaxian District General Hospital of Sanming,Sanming,Fujian,365500,China;Department of Clinical Laboratory,Shaxian District General Hospital of Sanming,Sanming,Fujian,365500,China)

机构地区：[1]三明市沙县区总医院全科医学科,福建三明365500 [2]三明市沙县区总医院内科,福建三明365500 [3]三明市沙县区总医院检验科,福建三明365500

出　　处：《现代生物医学进展》2025年第2期266-273,共8页Progress in Modern Biomedicine

摘　　要：目的:探讨血清胰岛素样生长因子-1(IGF-1)、胰岛素生长因子结合蛋白-3(IGFBP-3)水平与2型糖尿病(T2DM)患者糖脂代谢紊乱及颈动脉斑块不稳定性的关系。方法:选取2022年3月至2024年5月我院收治的246例T2DM患者(T2DM组)和体检健康的246例志愿者(对照组)。检测并比较两组血清IGF-1、IGFBP-3及糖脂代谢指标水平,采用Pearson法分析T2DM患者血清IGF-1、IGFBP-3与糖脂代谢指标表达的相关性。根据超声影像特征将T2DM患者分为无斑块组(n=84例)、稳定斑块组(n=59例)和不稳定斑块组(n=103例)。比较各组临床资料及血清IGF-1、IGFBP-3水平,并分析T2DM患者颈动脉斑块不稳定性的影响因素。结果:T2DM组高密度脂蛋白胆固醇(HDL-C)、血清IGF-1、IGFBP-3水平低于对照组(P<0.05);空腹血糖(FBG)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平高于对照组(P<0.05)。T2DM患者血清IGF-1、IGFBP-3与FBG、FINS、TC、TG、LDL-C水平呈负相关(r<0,P<0.05),与HDL-C水平呈正相关(r>0,P<0.05)。无斑块组、稳定斑块组、不稳定斑块组糖尿病病程、FBG、FINS、TC、TG、LDL-C、HDL-C、IGF-1、IGFBP-3比较差异具有统计学意义(P<0.05)。糖尿病病程延长、LDL-C水平升高是T2DM患者颈动脉斑块不稳定的独立危险因素(P<0.05),HDL-C水平升高、血清IGF-1水平升高、IGFBP-3水平升高是其保护因素(P<0.05)。结论:T2DM患者血清IGF-1和IGFBP-3水平降低,与机体糖脂代谢紊乱密切相关,二者水平升高是T2DM患者颈动脉斑块不稳定的保护因素。Objective:To investigate the relationship between serum insulin-like growth factor-1(IGF-1),insulin growth factor binding protein-3(IGFBP-3)levels and glucose and lipid metabolism disorders and carotid plaque instability in patients with type 2 diabetes mellitus(T2DM).Methods:246T2DM patients(T2DM group)and 246 healthy volunteers(control group)who underwent physical examination in our hospital from March 2022 to May 2024 were selected.The levels of serum IGF-1,IGFBP-3 and glucose and lipid metabolism indexes were detected and compared between two groups,the correlation between serum IGF-1,IGFBP-3 and glucose and lipid metabolism indexes in T2DM patients was analyzed by Pearson method.T2DM patients were divided into non-plaque group(n=84),stable plaque group(n=59)and unstable plaque group(n=103)according to the characteristics of ultrasound images.The clinical data and serum levels of IGF-1 and IGFBP-3 were compared among groups,and the influencing factors of carotid plaque instability in T2DM patients were analyzed.Results:The levels of high density lipoprotein cholesterol(HDL-C),serum IGF-1 and IGFBP-3 in T2DM group were lower than those in control group(P<0.05).The levels of fasting blood glucose(FBG),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)were higher than those in control group(P<0.05).Serum IGF-1 and IGFBP-3 were negatively correlated with FBG,FINS,TC,TG and LDL-C levels(r<0,P<0.05),and positively correlated with HDL-C levels(r>0,P<0.05).There were significant differences in the course of diabetes mellitus,FBG,FINS,TC,TG,LDL-C,HDL-C,IGF-1 and IGFBP-3 between non-plaque group,stable plaque group and unstable plaque group(P<0.05).Prolonged course of diabetes mellitus and elevated LDL-C levels were independent risk factors for carotid plaque instability in T2DM patients(P<0.05),elevated HDL-C levels,elevated serum IGF-1levels and elevated IGFBP-3 levels were protective factors(P<0.05).Conclusion:The decrease of serum IGF-1 and IGFBP-3 levels in T

关 键 词：2型糖尿病 胰岛素样生长因子-1 胰岛素生长因子结合蛋白-3 糖脂代谢紊乱 颈动脉斑块不稳定性 

分 类 号：R3[医药卫生—基础医学] R587.1