合并2型糖尿病对椎间盘退变患者血清半胱氨酸天冬氨酸蛋白酶9、B细胞淋巴瘤2表达水平的影响及其临床意义

Impact of concomitant type 2 diabetes mellitus on expression levels of serum cysteinyl aspartate specific prot-einase 9 and B-cell lymphoma-2 and its clinical significance in patients with intervertebral disc degeneration

目的探讨合并2型糖尿病对椎间盘退变患者血清半胱氨酸天冬氨酸蛋白酶9(Caspase-9)、B细胞淋巴瘤2(Bcl-2)表达水平的影响及其临床意义。方法根据是否合并2型糖尿病将343例椎间盘退变患者分为2型糖尿病组216例,非2型糖尿病组127例。比较两组血清Caspase-9、Bcl-2及炎症因子表达水平,以及腰椎间盘退变程度,分析2型糖尿病合并椎间盘退变患者血清Caspase-9、Bcl-2水平与椎间盘退变程度Pfirrmann评分的相关性以及两组患者Caspase-9和Bcl-2水平的相关性。结果 2型糖尿病组患者血清Caspase-9、白细胞介素(IL)-6、IL-18、C反应蛋白水平均高于非2型糖尿病组,血清Bcl-2水平低于非2型糖尿病组;2型糖尿病组患者L_(1/2)、L_(2/3)、L_(3/4)、L_(4/5)、L_(5)/S_(1)节段椎间盘Pfirrmann评分均高于非2型糖尿病组。2型糖尿病合并椎间盘退变患者血清Caspase-9水平与L_(1/2)、L_(2/3)、L_(3/4)、L_(4/5)、L_(5)/S_(1)节段椎间盘Pfirrmann评分均呈正相关,血清Bcl-2水平与L_(1/2)、L_(2/3)、L_(3/4)、L_(4/5)、L_(5)/S_(1)节段椎间盘Pfirrmann评分均呈负相关;两组患者血清Caspase-9水平与Bcl-2水平均呈负相关(均P<0.05)。结论患有2型糖尿病的椎间盘退变患者血清Caspase-9水平升高、Bcl-2水平降低,二者与椎间盘退变程度有关,可能共同调节细胞凋亡,从而加重椎间盘退变的程度。

Objective To investigate the impact of concomitant type 2 diabetes mellitus(T2DM)on the expression levels of serum cysteinyl aspartate specific proteinase 9(Caspase-9)and B-cell lymphoma-2(Bcl-2)and its clinical significance in patients with intervertebral disc degeneration.Methods A total of 343 patients with intervertebral disc degeneration were divided into T2DM group(216 cases)and non-T2DM group(127 cases)according to the presence of concomitant T2DM.The expression levels of serum Caspase-9,Bcl-2 and inflammatory factors as well as the degree of intervertebral disc degeneration were compared between the two groups,and the correlations of serum Caspase-9 and Bcl-2 levels with Pfirrmann score indicating the degree of intervertebral disc degeneration were analyzed in T2DM patients complicated with intervertebral disc degeneration,and the correlation between Caspase-9 and Bcl-2 levels was analyzed in both groups.Results The T2DM group exhibited higher levels of serum Caspase-9,interleukin(IL)-6,IL-18 and C-reactive protein,and lower serum Bcl-2 level as compared with the non-T2DM group;the T2DM group yielded higher Pfirrmann scores on L_(1/2),L_(2/3),L_(3/4),L_(4/5),L_(5)/S_(1) segments of intervertebral disc than the non-T2DM group.In T2DM patients complicated with intervertebral disc degeneration,serum Caspase-9 level positively correlated with Pfirrmann scores on L_(1/2),L_(2/3),L_(3/4),L_(4/5) and L_(5)/S_(1) segments of intervertebral disc,and serum Bcl-2 level negatively correlated with Pfirrmann scores on L 1/2,L 2/3,L 3/4,L 4/5 and L 5/S 1 segments of intervertebral disc;and serum Caspase-9 level negatively correlated with Bcl-2 level in both groups(all P<0.05).Conclusion Patients suffering from T2DM and intervertebral disc degeneration experience an elevation in serum Caspase-9 level and a reduction in Bcl-2 level.The two indicators correlate with the degree of intervertebral disc degeneration and may co-regulate cell apoptosis,thus increasing the severity of intervertebral disc degeneration.