2型糖尿病患者血小板膜糖蛋白Ib/IX/V复合物表达的研究

Expression of Platelet Glycoprotein Ib/IX/V Complex in Patients with Type 2 Diabetes Mellitus

目的观察2型糖尿病(T2DM)患者血小板膜糖蛋白(GP)Ib/IX/V复合物及其组分GPIbα的表达。方法将51例T2DM患者分为控制良好组(WCP组)和控制不良组(PCP组),并根据有无血管病变分为伴血管病变组(VD组)和不伴血管病变组(NVD组)。同时选取23例健康体检者为正常对照组(NC组)。检测受试者的生化指标、血小板GPIb/IX/V复合物和GPIbα的表达,并采用比浊法检测血小板最大聚集率(MA)。结果(1)PCP组空腹血糖(FPG)和糖化血红蛋白(HbA1c)与NC组、WCP组比较,差别有统计学意义(P<0.01);WCP组和PCP组的空腹胰岛素(FINS)、BMI、血脂(TC、TG、HDL、LDL)与NC组比较,差别有统计学意义(P<0.01)。(2)WCP组、PCP组GPⅠb/Ⅸ/Ⅴ复合物平均荧光强度(MFI)与NC组比较,差别有统计学意义(P<0.05);且PCP组GPⅠb/Ⅸ/Ⅴ复合物的MFI与WCP组比较,差别亦有统计学意义(P<0.05)。WCP组、PCP组GPⅠbαMFI与NC组比较,差别有统计学意义(P<0.01);且PCP组GPⅠbαMFI与WCP组比较,差别亦有统计学意义(P<0.01)。(3)相关性分析显示,T2DM患者GPⅠb/Ⅸ/Ⅴ复合物的MFI与FPG、HbA1c、FINS呈负相关(P<0.05);GPⅠbαMFI与FBG、HbA1c呈负相关(P<0.05)。结论T2DM患者不伴血管病变时即存在血小板活化,发生血管病变后活化更明显,且血小板活化与血糖呈正相关。血小板GPⅠb/Ⅸ/Ⅴ复合物作为凝血酶和血管性血友病因子的受体,可能参与了T2DM血管病变的发生、发展。

Objective To investigate the expression of platelet membrane glycoprotein （GP） Ⅰb/Ⅸ/Ⅴ complex and its constituent GP Ibedn patients with type 2 diabetes mellitus （T2DM）. Methods 51 T2DM patients were assigned to a well - controlled （WC） group and a poorly - controlled （PC） group, meanwhile they were divided into a vascular disease （VD） group and a non -vascular disease （NVD） group according to status of vascular lesion, and 23 normal subjects were chosen as the normal control （NC） group. The expressions of platelet GP Ⅰb/Ⅸ/Ⅴ complex and GP Ibetwere determined by flow cytometry, and platelet maximum agglutination （MA） by turbidity method. Results Compared with healthy subjects, the expressions of GP Ⅰb/Ⅸ/Ⅴ complex, GP Ibαin T2DM patients were significantly decreased （ P 〈0. 05 ）, and platelet MA were remarkably increased （ P 〈0. 05）. The expressions of GP Ⅰb/Ⅸ/Ⅴ complex, GP Ibetwere respectively lower in PCP and VD group than in WCP and NVD group （ P 〈 0. 05）, and platelet MA were respectively higher in PCP and VD group than in WCP and NVD group （ P 〈 0. 05 ）. The expressions of GP Ibαand GP Ⅰb/Ⅸ/Ⅴ complex were markedly negatively correlated to fast plasma glucose and glycosylated hemoglobin （ P 〈0. 05）. Conclusion Existing in the early stage of T2DM without diabetic angiopathies, platelet acti- vation is more obvious after diabetic angiopathies, and is positively correlated to blood glucose. As a receptor of thrombin and von Willebrand Factor, GP Ⅰb/Ⅸ/Ⅴ complex may contribute to the development of angiopathy in T2DM.