脂联素与2型糖尿病血管病变的关系

Adiponectin and type 2 diabetes mellitus patients with vascular complications

目的探讨脂联素(ADPN)与2型糖尿病(T2DM)患者血管病变的关系以及在不同血管并发症发病机制中的作用。方法选取T2DM患者80例,根据血管并发症情况分为糖尿病大血管病变组、糖尿病微血管病变组和单纯糖尿病组。比较各组间体质量指数(BMI)、腰臀比(WHR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA1c)和ADPN等水平的差别,观察血浆ADPN与上述指标间的相关性。结果糖尿病大血管病变组中BMI和HbA1c水平均高于单纯糖尿病组(P<0.05);糖尿病大血管病变组中BMI、WHR及HbA1c水平均高于糖尿病微血管病变组(P<0.05);糖尿病微血管病变组中HbA1c水平高于单纯糖尿病组(P<0.05)。糖尿病大血管病变组ADPN水平低于糖尿病微血管病变组和单纯糖尿病组(P<0.05);糖尿病微血管病变组ADPN水平低于单纯糖尿病组(P<0.05)。多元回归分析显示:糖尿病大血管病变组HbA1c(r=-0.446,P<0.01)和BMI(r=-0.361,P<0.05)与ADPN水平负相关;糖尿病微血管病变组WHR与ADPN水平负相关(r=-0.451,P<0.01);单纯糖尿病组HDL-C与ADPN水平正相关(r=0.587,P<0.01)。结论血浆ADPN水平下降可作为预测T2DM患者发生血管并发症的指标。血浆ADPN水平与HDL-C正相关,对于防治T2DM患者血管并发症发生有积极作用。

Objective To observe the changes of plasma adiponectin（ADPN） in type 2 diabetes mellitus（T2DM） patients with vascular complications and to explore the roles of ADPN in the pathogenesis of different vascular complications.Methods Eighty patients with T2DM were selected and divided into diabetes macroangiopathy group,diabetes microangiopathy group and simple diabetes group based on the condition of vascular complications.The levels of body mass index（BMI）,waist-hip ratio（WHR）,total cholesterol（TC）,triglycercide（TG）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein-cholesterol（HDL-C）,glycolated hemoglobin（HbA1c） and ADPN were measured and compared,and the correlations of plasma ADPN with these indicators were observed.Results The levels of BMI and HbA1c in diabetes macroangiopathy group were higher than those in simple diabetes group（P0.05）;The levels of BMI,WHR and HbA1c in diabetes macroangiopathy group were higher than those in diabetes microangiopathy group（P0.05）;The level of HbA1c in diabetes microangiopathy group was higher than that in simple diabetes group（P0.05）.The level of ADPN in diabetes macroangiopathy group was lower than that in diabetes microangiopathy group and simple diabetes group respectively（P0.05）;The level of ADPN in diabetes microangiopathy group was lower than that in simple diabetes group（P0.05）.Multiple regression analysis showed HbA1c（r=-0.446,P0.01） and BMI（r=-0.361,P0.05） were negatively correlated with ADPN in diabetes macroangiopathy group;WHR was negatively correlated with ADPN in diabetes microangiopathy group（r=-0.451,P0.01）;HDL-C was positive correlated with ADPN in simple diabetes group（r=0.587,P0.01）.Conclusion Lower blood plasma ADPN level can be serve as a predict indicators of vascular complications occurrence in T2DM patients.Blood plasma ADPN level is positive correlate with HDL-C,which has a positive effect on prevention and cure vascular complications occurrence in T2DM patients.