糖耐量异常及2型糖尿病患者血浆纤溶酶原激活物抑制物-1水平与动脉粥样硬化关系的探讨

Relationship between plasminogen activator inhibitor-1 and carotid intimal-medial thickness in impaired glucose tolerance and type 2 diabetes mellitus

目的探讨糖耐量异常(IGT)及2型糖尿病(T2DM)患者血浆纤溶酶原激活物抑制物-1(PAI-1)水平与颈动脉内膜-中层厚度(IMT)的关系,进而评价PAI-1水平与动脉粥样硬化的关系。方法以19例IGT患者(IGT组)和141例T2DM患者(T2DM组)为研究对象,并选择52例健康人作为对照组,测定PAI-1水平、IMT。结果(1)IGT组及T2DM组IMT与对照组比较差异有统计学意义;T2DM组IMT较IGT组明显增厚,差异有统计学意义。(2)对照组与IGT组、T2DM组PAI-1水平差异有统计学意义;IGT组与T2DM组PAI-1水平差异有统计学意义;合并大血管病变的T2DM组PAI-1水平与无大血管病变的T2DM组差异有统计学意义。(3)通过对IMT多元回归发现,PAI-1与IMT具有明显的相关性。结论(1)IGT阶段IMT就已经出现增厚,提示动脉粥样硬化在IGT阶段就已开始。临床T2DM阶段IMT明显增厚,且与IGT组的差异有统计学意义。(2)PAI-1水平与IMT密切相关,提示升高的PAI-1水平可能是IGT和T2DM大血管病变的重要危险因素之一。

Objective To evaluate the act of plasminogen activator inhibitor - 1 （PAI - 1 ） on atheroscleresis in impaired glucose tolerance（IGT） and type 2 diabetes mellitus（T2DM）. Methods The levels of PAI-1 were assayed by means of ELISA. The carotid intimal- medial thickness （IMT） was measured by high - resolution B mode ultrasonography. The relationship between PAI- 1 levels and IMT was studied. Results （ 1 ） The IMT in both IGT group and T2DM showed significant difference with that of the control group, and there was significant difference between IGT and T2DM. （2） The levels of PAI- 1 were different among three groups. IGT group and T2DM group showed higher levels. （3） The levels of PAI- 1 were correlated with IMT. Conclusions （ 1 ） IMT increases in IGT subjects. （2） The level of PAI- 1 is associated with IMT. Perhaps PAI- 1 is a significant risk factor for macrovascular complications in patients with T2DM and IGT.