血清成纤维细胞生长因子-21在2型糖尿病合并冠心病中的作用研究

Roles of serum FGF-21 in patients with type 2 diabetes mellitus complicated with coronary heart disease

目的探讨血清成纤维细胞生长因子-21(FGF-21)水平与2型糖尿病(T2DM)合并冠心病(CHD)的关系及其临床意义。方法选取单纯T2DM患者50例(T2DM组)、T2DM合并CHD患者48例(T2DM+CHD组)、单纯CHD患者47例(CHD组)、门诊健康体检者50例(对照组),用酶联免疫吸附法检测血清FGF-21水平,并测定空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇浓度,糖化血红蛋白和空腹血清胰岛素,计算胰岛素抵抗指数、体重指数及腰臀比,并作相关比较和分析。结果 T2DM+CHD组血清FGF-21水平均明显高于T2DM组、CHD组和对照组,差异均有统计学意义(q分别=3.55、3.74、3.96,P均<0.05);T2DM+CHD组FGF-21水平与腰臀比、三酰甘油和胰岛素抵抗指数呈正相关(r分别=0.195、0.255、0.189,P均<0.05);FGF-21和糖化血红蛋白是T2DM危险因素,FGF-21和三酰甘油是T2DM合并CHD的危险因素。结论血清FGF-21与T2DM合并CHD的发病有一定联系。

Objective To evaluate the relationship and the clinical value between fibroblast growth factor-21 （FGF-21） and type 2 diabetes mellitus complicated with coronary heart disease. Methods Serum samples were taken from 50 patients with T2DM, 48 patients with T2DM complicated with CHD, 47 patients with CHD and 50 normal controls. FGF-21 were measured by using ELISA;fasting blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high density lipoprotein cholesterol levels, HbAlc and fasting serum insulin and HOMA-IR, body mass index, waist to hip ratio were tested and calculated. The data was analyzed. Results The patients with T2DM complicated with CHD had significantly higher levels of FGF-21 than those of the T2DM group, CHD group and control group （q=3.55, 3.74, 3.96, P〈O.05）; Spearman analysis showed that the FGF-21 level was positively correlated with WHR, TG and HOMA-IR （r= 0.195,0.255,0.189, P〈0.05） ; Logistic analysis showed that FGF-21 and HbAlc were risk factors of T2DM; FGF-21 and TG were risk factors of T2DM complicated with CHD. Conclusions Serum FGF-21 probably related to the development of T2DM complicated with CHD to some extent.