2型糖尿病患者G蛋白偶联型β1和血管紧张素II1受体抗体与冠心病关系的研究

Relationship of autoantibodies against adrenergic β1 receptors and angiotensin II type 1 receptors with the coronary heart disease in T2DM patients

目的探讨T2DM患者血清抗血管紧张素II 1受体(AT1受体)和β1受体自身抗体(β1受体)与冠心病(CHD)的关系。方法采用随机对照的方法,选择T2DM患者371例(T2DM组)和健康对照者40名(NC组),以合成的AT1和β1受体多肽片段为抗原,应用ELISA法检测被试血清中抗G-蛋白偶联型AT1和β1受体自身抗体。使用超声心动图检查评价心脏结构和功能。多元Logistic回归分析T2DM患者CHD的影响因素。结果 (1)T2DM组抗AT1和β1受体抗体阳性率高于NC组(P<0.01)。(2)T2DM患者中,AT1受体抗体阳性组CHD发生率高于受体抗体阴性组(P<0.01);β1受体抗体阳性组CHD发生率高于受体抗体阴性组(P<0.01);(3)多元Logistic回归分析显示,病程、SBP、β1和AT1受体抗体4个危险因素与T2DM合并CHD相关(P<0.05)。结论 T2DM合并CHD可能与血清β1和AT1受体自身抗体参与有关,该抗体阳性预测T2DM合并CHD具有重要意义。

Objective To explore the relation of autoantibodies against angiotensin Ⅱ type 1 receptor （ATl-reeeptor） and β1 adrenergic receptor （β1-receptor） with the coronary heart disease in T2DM patients. Methods A total of 371 T2DM patients and 40 normal controls were enrolled. The epitopes of the second extracellular loop of β1 receptor （197-222） and AT1 receptor （165-191） were synthesized and used as antigen to screen the serum autoantibodies by ELISA. The cardiac structure and function was examined by the echocardiography. By multivariate logistic regressions, the risk factors for the T2DM patients with the coronary heart disease were analyzed. Results The positive rates of the autoantibodies against AT1 receptors and β1 receptors in T2DM patients were significantly higher than in healthy controls （P〈0. 01）. The incidence of the coronary heart disease in T2DM patients with positive autoantibodies against AT1 receptor was significantly higher than that with negative autoantibodies （P〈0.01）. The incidence of the coronary heart disease in T2DM patients with positive autoantibodies againstβ1 receptor was significantly higher than with negative autoantibodies （P〈 0. 01）. Multivariate logistic regression analysis showed that there were 4 risk factors related with the coronary heart disease in T2DM patients, including course of disease, systolic blood pressure, autoantibodies againstβ1 and AT1 receptors in the serum （P〈0.05）. Conclusion The autoantibodies against serum β1 and ATl-receptors are related with the coronary heart disease in T2DM patients. The positive rates of the autoantibodies are of an importantsignificance in forecasting the development of the T2DM accompanied CHD.