血浆脂联素水平与2型糖尿病及其大血管病变发生的相关性

Relationship of the plasma adiponetin level with type 2 diabetes and the macrovascular complications

目的：观察2型糖尿病及其并发大血管病变患者中的血浆脂联素水平，探讨血浆脂联素水平与2型糖尿病及其大血管病变的关系。 方法：选择2004-02／2005-02在广西医科大学附属第五医院内分泌科住院的2型糖尿病患者103例，根据是否合并大血管病变分为2组，糖尿病并大血管病变组49例，糖尿病无大血管病变组54例；同时选择在本院进行健康体检者35例作为对照组，均知情同意。测定以上观察对象的血浆脂联素水平应用放射免疫法，同时测定血糖、血压、血脂、C肽水平。比较各组间血浆脂联素水平、低脂联素血症发生率(以血浆脂联素水平<5mg／L判为降低)，分析其影响因素。探讨脂联素与糖尿病大血管并发症危险因素的相关性采用相关分析以及多元逐步回归分析。 结果：大血管病变组49例，无大血管病变组54例，正常对照组35例，全部进入结果分析。①各组血浆脂联素水平：糖尿病大血管病变组显著低于无大血管病变组和对照组[(4．08±3．24)mL／L，(6．69±4．42)mL／L，(16．37±3．03)mL／L，(t=3．440，17．606，P<0．01)]。无大血管病变组显著低于对照组(t=12．257，P<0．05)。②各组低脂联素血症发生率：大血管病变组、无大血管病变组均显著高于对照组[73．5％，40．0％，0(X^2=42．050，16．815，P<0．01)]，其中大血管病变组显著高于无大血管病变组(X^2=9．894，P<0．01)。③脂联素水平与糖尿病大血管并发症危险因素之间的相关性：血浆脂联素水平与收缩压呈负相关(r=-0．309，P<0．01)。 结论：2型糖尿病患者血浆脂联素水平降低，并发大血管病变者降低更加明显，且与糖尿病大血管病变的危险因素收缩压水平呈显著负相关，提示血浆脂联素与2型糖尿病及其大血管病变的发生发展密切相关。

AIM： To investigate the level of plasma adiponectin in type 2 diabetic patients and type 2 diabetic patients with maerovaseular complications so as to probe into the relationship of plasma adiponectin level with type 2 diabetes and maerovaseular complications. METHODS： From February 2004 to February 2005, 103 patients with type 2 diabetes were selected from the Department of Endocrinology, Fifth Affiliated Hospital of Guangxi Medical University. They were divided into type 2 diabetes with maerovaseular complication group and type 2 diabetes without maerovaseular complication group according to their maerovaseular complications. Meanwhile, 35 healthy people examined in the same hospital as above were selected for the control group. All the patients were informed consent. Their level of plasma adiponectin was measured with radioimmunoassay. Meanwhile, the level of blood pressure, blood glucose, lipids and C-peptide were measured. The level of plasma adiponectin and the incidence of hypoadiponectinemia（level of plasma adiponectin less than 5 mg/L） were compared among the three groups, and the factors influencing the level of plasma adiponectin were analyzed. The correlation between adipenectin and risk factors of macrovascular complications were analyzed by correlation analysis and multiple stepwise regression analysis. RESULTS： All the subjects were analyzed in the result; 49 in the type 2 diabetes with macrovascular complication group, 54 in the type 2 diabetes without macrovascular complication group and 35 in the control group. ① The level of plasma adiponectin in the type 2 diabetes with macrovascular complication group was significantly lower than that in the type 2 diabetets without macrovascular complication group and the control group [（4.08 ±3.24） mL/L vs （6.69±4.42）, （16.37±3.03） mL/L, t=3.440,17.606,P 〈 0.01], and it was also significantly lower in the type 2 diabetets without macrovascular complication group than in the control group （t=12.257,P 〈 0.05）. ②The incidence of hypoadiponectinemia in the type 2 diabetes with macrovascular complication and type 2 diabetes without macrovascular complication groups was significantly higher than that in the control group （73.5%, 40.0% vs 0, x^2=42.050,16.815,P 〈 0.01）, and it was significantly higher in the type 2 diabetes with macrovascular complication group than in the type 2 diabetes without macrovascular complication grou（x^2=9.894,P 〈 0.01）. ③The level of plasma adiponetin was negatively related to the systolic pressure in type 2 diabetic patients（r=-0.309, P=0.001） . CONCLUSION： The level of plasma adiponectin in type 2 diabetic patients is significantly decreased, especially more significantly in the those with macrovascular complications. The level of plasma adiponectin is in a negative correlation with the systolic pressure in the risk factors of type 2 diabetes with macrovascular complications, suggesting that the level of plasma adiponectin is closely related to the maerovaseular complications in type 2 diabetic patients.