2型糖尿病合并脑梗死患者脂联素水平的变化及其意义

The Value and Changes of Serum Adiponectin Level in Patients with Type 2 Diabetes Complicating Cerebral Infarction

目的探讨2型糖尿病合并脑梗死患者血清脂联素的变化规律及其与脑梗死的相关性。方法采用前瞻性观察研究临海市第一人民医院住院的2型糖尿病合并脑梗死患者38例(A组)、单纯2型糖尿病32例(B组)及正常对照组38例(C组),用酶联免疫法分别测定各组患者血清脂联素及C反应蛋白水平(CRP),并分析血清脂联素浓度与体质量指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、糖化血红蛋白(HbA1c)及CRP等各项指标的相关性。结果 A组、B组脂联素水平均显著低于C组(P<0.01),A组脂联素又显著低于B组(P<0.01);脂联素与BMI(r=-0.50,P<0.01)、HbA1c(r=-0.56,P<0.01)、CRP(r=-0.24,P<0.05)呈负相关,与HDL呈正相关(r=0.35,P<0.01);进入回归方程的因素为BMI(b=0.04,P<0.05)、HDL(b=-0.29,P<0.01)、HbA1c(b=0.03,P<0.01)、CRP(b=0.02,P<0.01)、脂联素(b=-0.32,P<0.01)。结论低脂联素水平是2型糖尿病合并脑梗死的独立危险因素。

Objective We aimed to investigate the changes of serum adiponectin concentrations in patients with cerebral infarction combined with type 2 diabetes mellitus and to study the correlation between them. Methods Serum adiponectin concentration and CRP were detelmined by ELISA. And the relevance among adiponectin, BMI, TC, TG, HDL, LDL, HbA lc and CRP were further ana- lyzed by multivariate logistic regression. Results We detected 108 patients （38 with type 2 diabetics and cerebral infarction as Group A, 32 with type 2 diabetics without cerebral infarction as Group B and 38 healthy persons as Group C）. Levels of adiponectin were significantly decreased in group A compared with group B （ P 〈 0.01 ）, while both groups were lower than group C （ P 〈 0.01 ）. There were negative correlation between adiponectin and BMI（ r = - 0.50, P 〈 O, 01 ）, HbA 1 c （r = - 0.56, P 〈 O. 01 ）, and CRP（ r = - 0.24, P 〈 0.05）. There were positive correlation between adiponectin and HDL（r = 0.35, P 〈 0.01 ）, BMI（b = 0.04, P 〈 0.05）. HDL（ b = - 0.29, P 〈 O. 01 ）, HbA1 c（ b = 0.03, P 〈 0.01 ）, CRP（ b = 0.02, P 〈 O. 01 ） and adiponectin（ b = - 0.32, P 〈 0.01 ） were entered in the regression equation. Conclusions Lower level of adiponectin is a potential risk factor of cerebral infarction in type 2 diabetics.