不同性别2型糖尿病患者分泌型CD36水平变化及颈动脉内膜中层厚度的影响因素研究

Changes of Solubel CD36 in Type 2 Diabetes Mellitus by Gender and Analysis on the Influencing Factors of Carotid Intima-Media Thickness

目的探讨不同性别2型糖尿病(T2DM)患者血清分泌型CD36(sCD36)的分布情况及T2DM患者颈动脉内膜中层厚度(IMT)的影响因素。方法选取66例2型糖尿病患者(男46例,女20例),其中女性患者均已绝经。检测受检者的sCD36、糖化血红蛋白(HbA1c)、血脂〔三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)〕、颈动脉IMT,测量腹围,计算体质指数(BMI)。按性别不同分为两组,评价性别对2型糖尿病患者sCD36的影响;以颈动脉IMT≥1.0 mm为界,将患者分为IMT增厚组和非增厚组,分析影响2型糖尿病患者颈动脉IMT的因素。结果女性T2DM患者的sCD36〔(495.8±288.4)ng/L〕较男性T2DM〔(327.5±142.5)ng/L〕患者显著升高,差异有统计学意义(P<0.01);Logistic回归分析显示,年龄是影响糖尿病患者颈动脉IMT的独立危险因素(OR=1.089,P<0.01)。结论绝经期女性2型糖尿病患者的血清sCD36水平较男性升高,可能是导致女性动脉粥样硬化的原因之一;年龄是2型糖尿病患者颈内动脉中内膜增厚的危险因素。

Objective To investigate the distribution of soluble CD36（sCD36） in patients with type 2 diabetes mellitus（T2DM） of different gender and the influencing factors of the carotid intima-media thickness（IMT）.Methods Totally 66 T2DM patients（46 men and 20 postmenopausal women） were enrolled.The sCD36,waistline,body mass index（BMI）,glycated hemoglobin（HbA1c）,triglyceride（TG）,cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）,and carotid IMT were measured.Patients were divided into two groups by gender to evaluate the impact of gender on the distribution of sCD36.With ITM≥1 mm defined as intimal thickening,patients were divided into IMT group and non-IMT group.The influencing factors of IMT were analyzed.Results The level of sCD36 were（（495.8±288.4） ng/L） in the female T2DM group,which was significantly higher than that in male T2DM group（（327.5±142.5） ng/L）（P0.01）.Age was an independent risk factor in the IMT group（OR=1.089）（P0.01）.Conclusion The sCD36 level is higher in postmenopausal women with T2DM than in men,which may be one of the reasons why women are more easily to develop atherosclerosis.Age is a risk factor for atherosclerosis in T2DM patients.