2型糖尿病大血管病变与视黄醇结合蛋白4及高敏C反应蛋白关系的研究

Relationship between serum concentrations of retinol-binding protein 4 and high sensitive C reactive protein and macrovascular complications in type 2 diabetic mellitus patients

目的 探讨2型糖尿病（T2DM）大血管病变患者血清视黄醇结合蛋白4（RBP4）及高敏C反应蛋白（hs-CRP）水平的变化.方法 入选研究对象115例,其中单纯T2DM组40例,T2DM大血管病变（病变T2DM）组40例,对照组35例.检测其空腹血清RBP4、hs-CRP,同时测空腹血糖（FBG）、身高、体重、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆同醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）,计算体重指数（BMI）和稳态模型评估法胰岛素抵抗指数（HOMA-IR）.分析三组RBP4水平的变化,及其与上述其他指标的相关性.结果 hs-CRP、RBP4在病变T2DM组和单纯T2DM组显著高于对照组[hs-CRP分别为（9.12±4.21）、（2.01±1.96）、（0.98±0.36）mg/L,RBP4分别为（30.10±5.45）、（20.02±5.32）、（12.02±3.45）mg/L]（P〈0.01）,病变T2DM组显著高于单纯T2DM组（P〈0.01）.单因素相关分析显示RBP4与LDL-C、BMI、FBG、hs-CBP、FINS、HOMA-IR呈正相关（相关系数分别为0.325、0.597、0.323、0.571、0.275、0.463,P〈0.05或〈0.01）.结论 血清RBP4、hs-CRP在糖尿病患者中显著升高,其水平变化与糖尿病大血管并发症的发生、发展密切相关.

Objective To investigate the levels of serum retinol-binding protein 4 （RBP4） and high sensitive C reactive protein （hs-CRP） in type 2 diabetic mellitus （T2DM） patients with macrovascular complications. Methods All of 115 subjects were divided into 3 groups： normal control group （35subjects）, T2DM patients with macrovascular complications group （40 subjects） and simple T2DM patients group （40 subjects）. Serum RBP4 and hs-CRP was detected and fasting blood glucose（FBG）, glycosylated hemoglobin A1c （HbA1c）, triacylglycerol （TG）, total cholesterol （TC）, high density lipopretein cholesferel （HDL-C）, low density lipoprotein cholesferol（LDL-C） and fasting insulin（FINS） were measured. Body mass index （BMI） and HOMA-IR was calculated. The correlation of RBP4 and other factors were analyzed.Results The concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group and simple T2DM patients group compared with those in normal control group [hs-CRP：（9.12±4.21）,（2.01±1.96）, （0.98±0.36）mg/L; RBP4：（30.70 ± 5.45）, （20.02±5.32）,（12.02±3.45）mg/L] （P〈0.01）. Also,the concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group compared with those in simple T2DM patients group （P〈0.01）. Univariate analysis showed that serum RBP4 was positively associated with LDL-C,BMI,FBG,hs-CRP,FINS,HOMA-IR （r=0.325, 0.597, 0.323, 0.571, 0.275, 0.463,P〈0.05 or 〈0.01）.Conclusions The concentrations of RBP4 and hs-CRP are significantly higher in T2DM patients. The changes of RBP4 and hs-CRP are closely related to the occurrence and development of diabetic macrovascular complications.