2型糖尿病患者糖耐量正常的一级亲属血浆sRAGE水平及相关因素的分析

Study of the plasma level of sRAGE and other related factors in first-degree relatives with normal glucose tolerance of Type 2 Diabetes

目的探讨2型糖尿病患者糖耐量正常的一级亲属血浆sRAGE水平及其与各代谢性疾病危险因素之间的相关性。方法应用酶联免疫法测定51例2型糖尿病糖耐量正常一级亲属及48例正常对照者血浆sRAGE水平,测量腰围(WC)、臀围(WC)、体质量、收缩压(SBP)、舒张压(DBP),并检测甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS),计算腰臀比(WHR)、体质量指数[BMI=体质量(kg)/身高(m2)]和胰岛素抵抗指数[HOMA-IR=(FBG×FINS)/22.5]等相关指标,运用两样本t检验比较两组人群上述指标间的差异,运用Pearson相关分析和多元线性逐步回归分析观察组血浆sRAGE水平同SBP、DBP、WC、HC、BMI、TG、TC、HDL-C、LDL-C、HOMA-IR之间的关系,探索观察组人群特点。以BMI=25为切点,将观察组分为体质量指数正常组和超重肥胖组,并对血浆sRAGE水平进行比较,进一步验证BMI与sRAGE的关系。结果与对照组相比,观察组TG、FINS、HOMA-IR水平显著升高(P<0.05),HDL-C、sRAGE水平明显降低(P<0.05);血浆sRAGE水平与BMI、WC、HC、WHR、FBG呈明显负相关(P<0.05);BMI是血浆sRAGE的独立相关因素(复相关系数R2=0.145)。超重肥胖组的sRAGE水平明显低于体质量指数正常组(P<0.05)。结论 2型糖尿病患者糖耐量正常一级亲属血浆sRAGE水平较正常人群降低,BMI的升高是其下降的独立危险因素。

objective To investigate the association between plasma levels of the soluble form of RAGE（sRAGE） and cardiometabolic risk factors in first-degree relatives of Type 2 Diabetes with normal glucose tolerance.Methods Plasma levels of sRAGE were detected by ELISA in 51 first-degree relatives of type 2 diabetes patients with normal glucose tolerance and 48 normal controls.The WC,HC,body mass,SBP and DBP were measured.In addition,other clinical indexes,including TG,TC,HDL-C,LDL-C,and FINS,were also tested.WHR,BMI,and the insulin resistance index（HOMA-IR） were calculated according to the formulas.The differences of the above indexes between the two groups were analyzed by t test and the association between sRAGE and these indexes in the observation group was analyzed by Pearson′s correlation and multiple regression analysis.The observation group of first-degree relatives was divided into two subgroups with the cutoff point of BMI=25.The level of sRAGE was further analyzed in the subgroups to prove the relationship between BMI and sRACE.Results The levels of TG,FINS and HOMA-IR were significantly higher than those of the normal controls（P0.05）.However,the levels of HDL-C and sRAGE were significantly lower in the first-degree relative group compared to those of the normal controls（P0.05）.Plasma sRAGE was negatively correlated with BMI,WC,HC,WHR,and FBG（P0.05）,and BMI was an independent association factor of sRAGE（R2=0.145）.Also,plasma sRAGE was significantly lower in the overweight and obese subgroup than that in the subgroup of normal BMI（P0.05）.Conclusions The level of plasma sRAGE in first-degree relatives of Type 2 Diabetes patients with normal glucose tolerance is significantly lower than that in normal people,and BMI is an independence hazard factor.