基质金属蛋白酶-9及胰岛素抵抗与2型糖尿病颈动脉粥样硬化的相关性研究

Relationship of Matrix Metalloproteinase-9 and Insulin Resistance with Intimal-media Thickness of Carotid Artery in Type2 Diabetic Patients

目的研究2型糖尿病患者基质金属蛋白酶-9(MMP-9)及胰岛素抵抗与颈动脉粥样硬化的关系。方法采用ELISA法分别检测正常人25例(对照组)、按体重指数(BMI)分成糖尿病非肥胖组26例和糖尿病肥胖组34例患者的血清MMP-9水平和胰岛素抵抗指数(HOMA-IR)等生化指标,应用彩色多普勒超声测量颈动脉内膜中层厚度(IMT)进行相关分析。结果糖尿病2组的HbA1c、FPG、FINS、HOMA IR、MMP-9、IMT的指标较对照组明显增高(P<0.05或0.01),糖尿病肥胖组的FINS、HOMA IR、MMP-9的水平均高于非肥胖组(P<0.05或0.01),而HbA1c、FPG、IMT相比较没有显著性差异(P>0.05)。相关分析表明糖尿病2组血清MMP-9和HOMA-IR指标与IMT呈正相关。结论2型糖尿病患者颈动脉粥样硬化病变严重程度与血清MMP-9和HOMA-IR增高有密切的关系。

Objective To investigate the relationship of matrix metalloproteinase-9 （MMP- 9） and insulin resistance（HOMA-IR） with intimal-media thickness（IMT） of carotid artery in type2 diabetic patients. Methods Serum levels of MMP-9 were determined by enzyme linked immuneosorbent assay（ELISA） in 34 obesities of type2 diabetes mellitus and 26 non-obesities of type 2 diabetes mellitus. Their intimal-media thickness（IMT） of carotid artery and HOMA-IR were also measured and analyzed. 25 individuals without diabetics were taken as the control group. Results The serum levels of HbAlc, FPG, FINS, MMP-9 and HOMA-IR, IMT in the two observed groups with diabetics were much higher than that in the control group （ P 〈 0.05 or 0.01）. The levels of FINS, HOMA IR, MMP-9 in the observed group with obesities were significantly higher than that in the observed group with non-obesities（P〈0.05 or 0.01）. However, there was not much difference between the levels of HbAlc, FPG, （P 〉0.05）. Linear regression analysis showed that serum levels of MMP-9, HOMA-IR were positively correlated with IMT. Conclusion The severity of carotid atherosclerosis in type 2 diabetics mellitus is closely associated with the increase of MMP-9 and HOMA-IR.