不同肾功能2型糖尿病患者血浆α2-HS-糖蛋白与下肢动脉粥样硬化的相关性研究

Correlation between plasma AHSG level and lower extremity atherosclerosis in type 2 diabetes complicated with renal insufficiency

目的探讨不同肾功能状态下T2DM患者血浆α2-HS-糖蛋白(AHSG)水平与下肢动脉粥样硬化(AS)程度的关系及其相关因素分析。方法 T2DM患者226例,按肾小球滤过率估计值(eGFR)分为肾功能正常组(A组),肾功能轻度下降组(B组),肾功能中重度下降组(C组)。所有患者采用彩色多普勒超声仪进行双下肢AS检查,并通过ELISA法进行血浆AHSG水平检测,分析不同肾功能状态下二者的关系。结果 (1)C组下肢AS发生率和评分高于A、B组,血浆AHSG水平低于A、B组,差异均有统计学意义(P<0.01)。(2)A、B组血浆AHSG水平与下肢AS评分无相关性(P>0.05),C组中二者呈正相关(r=0.592,P<0.01)。(3)逐步回归分析显示C组HbA1c、TC、TG、eGFR、AHSG是下肢动脉硬化程度的影响因素(P<0.05或P<0.01)。结论在肾功能中、重度下降时血浆AHSG水平是衡量T2DM下肢AS严重性的指标之一。

Objective To investigate the correlation between plasma AHSG level and lower extremity atherosclerosis(LEA) in type 2 diabetes complicated with renal insufficiency.Methods According to the estimated glomerular filtration rate(eGRF),226 cases of type 2 diabetes were divided into group A with normal renal function(n=81),group B with mild renal insufficiency(n=46),and group C with moderate to severe renal insufficiency(n=99).Severity of LEA was examined by color Doppler ultrasound and plasma AHSG level was measured by ELISA.The correlation between plasma AHSG level and severity of LEA was analyzed among different groups.Results(1) The LEA incidence and LEA scores were higher in group C than in group A and group B.The plasma AHSG level was lower in group C(P<0.01).(2) There was no correlation between plasma AHSG level and LEA both in group A and group B(P>0.05),whereas there was a positive correlation between plasma AHSG level and LEA in group C(r=0.592,P<0.01).(3) Multiple stepwise regression analysis showed that HbA1c,TC,TG,GFR and AHSG were primary factors of LEA in group C(P<0.05 or P<0.01).Conclusion Plasma AHSG level can be used as a measurable marker of LEA severity in type 2 diabetes complicated with moderate-severe renal insufficiency.