糖调节受损患者血清脂联素、E选择素和血管细胞黏附分子-1的水平及意义

Clinical analysis of adiponectin,E-selection and VCAM-1 in patients with impaired glucose regulation

目的探讨糖调节受损(IGR)患者血清脂联素、E选择素和血管细胞黏附分子-1(VCAM-1)的水平及其与糖脂代谢指标的相关性,为IGR的发病机制和防治提供循证依据。方法选取80例IGR患者(IGR组)、48例2型糖尿病患者(T2DM组)和40例正常人(NGT组)进行血糖和胰岛素等检测。结果①NGT组、IGR组和T2DM组的脂联素水平依次降低,E选择素和VCAM-1水平依次升高(P均<0.05)。②脂联素与E选择素、VCAM-1呈负相关(r=-0.628,-0.321;P均<0.01),E选择素与VCAM-1呈正相关(r=0.351,P<0.01)。③影响脂联素的主要因素有WHR、HDL和LDL,影响E选择素的主要因素有WHR、HbA1c、LDL,影响VCAM-1的主要因素有WHR、HbA1c、TG、HDL、LDL。结论在IGR阶段,脂联素、E选择素和VCAM-1已出现明显异常,已经有胰岛素抵抗的加重和血管内皮细胞损伤的发生;IGR患者腹型肥胖、长期高血糖和高LDL血症是影响脂联素、E选择素和VCAM-1的主要因素。

Objective To investigate the serum concentrations of adiponectin, E-selection and vascular cell adhesion molecule-1（ VCAM-1 ） in patients with impaired glucose regulation （IGR）, and analyze the relationship between these markers and glucose and lipid metabolism. Methods The 80 cases meeting the diagnostic criteria of IGR were the IGR group, the 48 eases meeting the diagnostic criteria of type 2 diabetes mellitus were the T2DM group, the other 40 people with normal glucose tolerance were the healthy control group, the related data of these three group were analyzed. Results ①In NGT group, IGR group and T2DM group, adiponectin decreased while E-selection and VCAM-1 increased. ②A adiponeetin had a negative correlation with E-selection and VCAM-1, while E-selection had a positive correlation with VCAM-1. ③The main factors of adiponectin were WHR, HDL and LDL, the main factors of E-selection were WHR, HbA1c,LDL,the main factors of VCAM-1 were WHR,HbA1c ,TG,HDL,LDL. Conclusions In IGR stage, the level of serum adiponectin, E-selection and VCAM-1 concertrations has already been abnormal, which means the worse of insulin resistance and the occurrence of vascular endothelial cell injury. Abdominal obesity, long-term high blood glucose and hyperlipidemia are the main factors of adiponectin, E-selection and VCAM-1.