老年2型糖尿病患者血清炎症因子水平及其与大血管病变的相关性

The level of the serum inflammatory factors and their relationship with cardiocerebral vascular diseases in elderly patients with type 2 diabetes mellitus

目的观察2型糖尿病患者血清炎症因子水平的变化,探讨炎症因子对2型糖尿病尤其老年患者合并心脑血管病变的影响。方法 103例2型糖尿病患者按年龄及是否合并心脑血管病变分别分组。用自动生化分析仪测定所有患者血清高敏C反应蛋白(hsC-RP)、FBG、HbA1c、TC、TG、LDL-C水平,用EL-ISA方法测定血清白介素6(IL-6)和肿瘤坏死因子α(TNF-α)水平。结果 (1)2型糖尿病患者年龄≥65岁者,血清hsCRP、TNF-α、IL-6水平均高于年龄<65岁者(P<0.01)。(2)合并心脑血管病变者,血清hsC-RP水平较高于无心脑血管病变者(P<0.05)。年龄≥65岁中合并心脑血管病变者,血清hsC-RP水平高于无心脑血管病变者(P<0.05)。(3)血清hsCRP水平与年龄和血清TG水平呈正相关(r=0.257,P<0.01;r=0.220,P<0.01)。影响hsC-RP的因素主要为年龄,回归方程为y(hsC-RP)=2.407+0.100年龄。(4)2型糖尿病中≥65岁者合并心脑血管病变的发生率高于<65岁者(P<0.01)。结论 hsC-RP与大血管病变相关,但IL-6和TNF-α与大血管病变无明显相关性;年龄增长是血清hsC-RP水平升高的主要影响因素。

Objective To investigate the serum levels of the inflammatory factors and their relationship with cardiocerebral vascular disease in type 2 diabetes mellitus. Methods The 103 patients with type 2 diabetes mellitus were divided into groups with and without cardiocerebral vascular disease and groups at age of 〈65 and ≥65 years. We detected the levels of serum hsC-RP, fasting blood glucose （FBG）, glycosylated hemoglobin （GHbA1c）, cholesterol total （TC）, triglyceride （TG）, low density lipoprotein-C（LDL-C）, serum TNF-α and IL-6. Results （1）The levels of serum hsC-RP, TNF-α and IL-6 were higher in patients of age≥65 years than of aged 65 years （P = 0. 003, P = 0. 001, P= 0. 007）. （2）The level of serum hsC-RP was higher in patients with cardiocerebral vascular disease （CCVD） than without CCVD（P=0. 015）. The level of serum hsC-RP was higher in patients with CCVD and at age of 65 years than in patients without CCVD（P=0. 040）. （3）Serum hsC-RP was positively correlated with age and serum TG（r=0. 257,P=0. 000;r=0. 220,P=0. 003）. The influencing factor for hsC-RP was age. （4）The incidence rate of CCVD in type 2 diabetes mellitus patients at age≥65 years was higher than patients at age〈（65 years （P = 0. 000）. Conclusion The serum hsC-RP is positively correlated with cardiocerebral vascular disease in T2DM, but IL-6 and TNF-α are not significantly associated with CCVD. And age is a main influencing factor for hsC-RP.