初发2型糖尿病患者血清vaspin水平与颈动脉斑块的相关性

Association of serum vaspin with carotid plaque in new type 2 diabetic patients

目的探讨初发2型糖尿病(T2DM)患者血清vaspin水平与血糖、血脂、胰岛素抵抗等代谢因素及糖尿病早期颈动脉粥样硬化的关系。方法选择初发T2DM患者69例,根据有无颈动脉斑块分为糖尿病无斑块组(男17例,女15例)和糖尿病伴斑块组(男20例,女17例),另外选择年龄、性别相匹配的健康查体者为对照组(男15例,女11例)。测定收缩压(SBP)、腰围(WC)、胰岛素抵抗指数(HOMA-IR)等指标,采用ELISA方法测定血清vaspin水平。结果校正年龄、性别后,糖尿病无斑块组的血清vaspin水平显著高于对照组[(0.66±0.22)ng/mLvs(0.46±0.12)ng/mL,P<0.01],而糖尿病伴斑块组血清vaspin水平低于无斑块组[(0.52±0.22)ng/mL vs(0.66±0.22)ng/mL,P<0.05]。偏相关分析显示,血清vaspin与HOMA-IR呈负相关(r=-0.276,P=0.025)。Logistic回归分析结果显示,SBP和vaspin水平是糖尿病发生颈动脉硬化的独立相关因素。结论血清vaspin水平在初发T2DM人群中升高,血清vaspin水平下降可能与初发T2DM患者颈动脉斑块形成有关联。

Objective To explore the association of serum vaspin with serum glucose,serum lipid,insulin resistance, and the presence of carotid plaque in early stage of type 2 diabetes.Methods Sixty-nine type 2 diabetic patients with less than 1 year diabetes duration were divided into two groups by the presence or absence of carotid plaque.Twenty-six age-matched healthy controls were recruited as well.Serum vaspin was measured by enzyme-linked immunosorbent assay. Results After age and gender were adjusted,the fasting serum vaspin levels were significantly higher in the diabetic patients without carotid plaque than the controls[（0.66±0.22） ng/mL vs（0.46±0.12） ng/mL,P0.01]. However,the circulating vaspin level was much lower in the diabetic subjects with carotid plaque than those without [（0.52±0.22） ng/mL vs（0.66±0.22） ng/mL,P0.05].Partial correlations demonstrated that the vaspin level was negatively correlated with HOMA-IR（r= -0.276,P=0.025） in all subjects.Logistic regression analysis showed that SBP and the fasting serum vaspin levels were significantly associated with the presence of carotid plaque in type 2 diabe- tes.Conclusion Serum vaspin is significantly elevated in type 2 diabetic patients and its level is negatively associated with the presence of carotid plaque,indicating that vaspin might play a compensative role in the early course of diabetes while exerting protective effects on atherosclerosis in the early stage of diabetes.