脂蛋白相关磷脂酶A2水平与糖尿病患者血管内皮功能及动脉弹性的相关性研究

Association of lipoprotein-associated phospholipase A2 levels with vascular endothelial function and arterial elasticity in type 2 diabetes mellitus

目的:探讨2型糖尿病患者脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)水平与血管内皮功能及动脉弹性之间的关系。方法:收集在南京医科大学第一附属医院就诊的163例2型糖尿病患者的病例资料,采用胶乳散射免疫比浊法测定血浆Lp-PLA2水平,运用无创外周动脉张力法测定反应性充血指数(reactive hyperemia index,RHI)以评估血管内皮功能,通过脉搏波传导速度(pulse wave velocity,PWV)测定动脉弹性,分析Lp-PLA2水平与血管内皮功能及动脉弹性之间的相关性。结果:在2型糖尿病患者中,伴随Lp-PLA2水平升高,RHI逐渐降低(r=-0.23,P<0.01),而Lp-PLA2与PWV之间则无明显相关性(r=0.13,P=0.17)。进一步多元线性回归分析发现,校正了年龄、性别、低密度脂蛋白胆固醇、糖化血红蛋白、吸烟及体重指数等因素后,Lp-PLA2依然是RHI的独立相关因素(β=-0.231,P=0.027)。结论:血浆Lp-PLA2水平检测有望成为评估2型糖尿病患者血管内皮功能的可靠手段。

Objective:To investigate the relationship between lipoprotein-associated phospholipase A2(Lp-PLA2)levels and vascular endothelial function and arterial elasticity in type 2 diabetes mellitus(T2DM)patients.Methods:A total of 163 individuals with T2DM who were admitted to the First Affiliated Hospital of Nanjing Medical University were enrolled.Latex scattering immunoturbidimetric assay was used to determine plasma Lp-PLA2 levels.Noninvasive peripheral arterial tone measurement(PAT)was performed to evaluated endothelial function by reative hyperemia index(RHI),and pulse wave velocity(PWV)were used to determine the arterial elasticity.Results:In T2DM patients,the vascular endothelial function index(RHI)gradually decreased with the increase of LP-PLA2 level(r=-0.23,P<0.01),whereas there is no significant correlation between Lp-PLA2 and PWV(r=0.13,P=0.17).Further multiple linear regression analysis showed that Lp-PLA2 remained as an independent factor for RHI after adjusting for age,gender,LDL-cholesterol,glycosylated hemoglobin,smoking,and body mass index(β=-0.231,P=0.027).Conclusion:Plasma LpPLA2 may be a suitable surrogate marker for evaluation of vascular endothelial function.