2型糖尿病合并冠心病患者血清内脂素和视黄醇结合蛋白4的临床意义

The Roles of Serum Visfatin and Retinol Binding Protein 4 in Patients with Type2 Diabetes Mellitus Complicated with Coronary Heart Disease

目的探讨血清内脂素（visfatin）和视黄醇结合蛋白4（RBP4）水平与2型糖尿病（T2DM）合并冠心病（CHD）的临床意义。方法选取单纯T2DM（T2DM组）患者61例、T2DM合并CHD（T2DM＋CHD组）患者58例、单纯CHD（CHD组）患者60例、门诊健康体检者（对照组）60例，检测各组血清内脂素、RBP4水平、空腹血糖（FBG）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平，HbAlc和空腹血清胰岛素（FINS），计算胰岛素抵抗指数（HOMA—IR）、体重指数（BMI）及腰臀比（WHR），并作相关性分析。结果T2DM＋CHD组血清内脂素和RBP4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=2．56—3．13，均P〈0．05）。T2DM＋CHD组内脂素水平与WHR、RBP4、TG和HOMA．IR呈正相关（r=0．27—0．52，均P〈0．05）；T2DM与RBP4和HbAlc密切相关（OR=2．09～3．67，P=0．05），T2DM合并CHD与内脂素、RBP4和TG密切相关（OR=2．13～3．81，P=0．05）。结论血清内脂素和RBP4与T2DM合并CHD的发病有一定联系。

Objective To evaluate the roles and clinical significance of visfatin, RBP4, T2DM with CHD in patients. Methods Serum sample were taken from 61 patients with T2DM, 58 patients with T2DM complicated with CHD, 60 patients with CHD and 60 normal controls, visfatin and RBP4 were measured with EHSA, and we also measured the fasting blood glucose（FBG）, total choles- terol（TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, low-density lipoprotein cholesterol （LDL-C） levels, HbAlc and fasting serum insulin（HNS）, HOMA-IR, body mass index （BMI） and waist to hip ratio（WHR）, Spearman analysis and Logistic analysis were used. Results The patients with T2DM complicated with CHD had significantly higher levels of visfatin and RBP4 than T2DM group, CHD group and control group（q = 2.56 - 3.13, all P 〈 0.05） ; Spearman analysis showed the visfatin level was positively correlated with WHR, RBP4, TG and HOMA-IR （r= 0.27～0.52,all P 〈 0.05）, Logistic analysis showed RBP4 and HbA1 c were closely related to T2DM （ B = 0.69, P = 0.02; B = 0.16, P = 0.02） ; visfatin, RBP4 and TG were closely related to T2DM complicated with CHD （ B = 0.63, P = 0.04; B = 0.75, P = 0.03 ; B = 0.98, P =0.03）. Conclusions Serum visfatin and RBP4 may play an important role in the development of T2DM complicated with CHD.