血清抵抗素、肿瘤坏死因子-α水平与2型糖尿病患者血管内皮功能紊乱的相关性研究

STUDY ON THE CORRELATION BETWEEN SERUM RESISTIN,TUMOR NECROSIS FACTOR-α LEVELS AND VASCULAR ENDOTHELIAL CELL DYSFUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

目的探讨血清抵抗素(resistin)、肿瘤坏死因子-α(TNF-α)水平与2型糖尿病(T2DM)患者血管内皮功能紊乱的关系。方法测定60例T2DM患者及20例健康人(正常对照组)血清中抵抗素、TNF-α、血管性血友病因子(vWF)、C反应蛋白(CRP)及一氧化氮(NO)的水平,分别将以上检测结果进行比较。结果T2DM组血清抵抗素、TNF-α、vWF、CRP水平均高于正常对照组(P<0.01或P<0.05),而NO低于正常对照组(P<0.01);其中抵抗素与TNF-α、vWF、CRP呈正相关(r分别为0.47、0.32、0.42,均P<0.05);TNF-α与vWF、CRP亦呈正相关(r=0.30,P<0.05;r=0.42,P<0.01);抵抗素、TNF-α与NO呈负相关(r分别为-0.47、-0.34,均P<0.01);多元线性回归分析显示血清NO、vWF、CRP分别与抵抗素或TNF-α存在显著的相关性(均P<0.05)。结论血清抵抗素、TNF-α水平可能与T2DM患者血管内皮功能紊乱有关,是预测T2DM血管并发症有价值的指标。

Objective To investigate the relationship between serum levels of resistin,tumor necrosis factor - α（TNF-α） and vascular endothelial dysfunction in type 2 diabetes mellitus（T2DM）. Methods Serum resistin , TNF - αand nitric oxide （ NO）, yon Willebrand factor （ vWF）, C - reactive protein （CRP） levels were measured in 60 cases of T2DM and 20 normal controls. The results were compared with the clinical and laboratory indexes in the two groups. Results The levels of serum resistin, TNF - α, vWF, CRP were remarkably higher, NO were significantly lower in type 2 diabetic patients than those in control group （ P 〈 0.01 or P 〈 0.05 ）. Correlation analysis showed that the resistin level was positively correlated with TNF - α, vWF, CRP （ r = 0.47, r = 0.32, r = 0.42 ; P 〈 0.05 ） The TNF - αlevel was positively correlated with vWF, CRP（ r = 0.30, P 〈 0.05 ; r = 0.42, P 〈 0.01 ） ; Both resistin and TNF - αwere negatively correlated with NO（ r = - 0.47, r = - 0.34 ; P 〈 0.01 ）. In type 2 diabetic patients,mutiple linear regression analysis revealed that serum NO.vWF.CRP was significantly correlated with serum resistin or TNF -α（ P 〈0.05 ）. Conclusion Serum resistin and TNF -αmay be related to vascular endothelial dysfunction in T2DM,and may be valuable indexes to predict diabetic vascular complications.