2型糖尿病患者血清chemerin和C反应蛋白水平及胰岛素抵抗与大血管病变的相关性研究

Study on Serum Chemerin,CRP and Insulin Resistance and Macroangiopathy in Type 2 Diabetes Mellitus

目的探讨2型糖尿病患者血清chemerin、C反应蛋白(CRP)水平及胰岛素抵抗(IR)与大血管病变的关系。方法选取2010—2011年桂林医学院附属医院住院及门诊的2型糖尿病患者60例,根据是否发生大血管病变,将患者分为单纯糖尿病组(30例)和糖尿病大血管病变组(30例);另选取同期来自宣教活动积累的同年龄段健康者30例作为对照组。采用双抗体夹心酶联免疫吸附测定(ELISA)法检测3组受检者的血清chemerin水平,免疫比浊法检测CRP水平,同时测定各组身高、体质量、收缩压、舒张压、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、颈动脉内膜厚度,计算体质指数(BMI)及胰岛素抵抗指数(HOMA-IR)。结果 (1)对照组、单纯糖尿病组、糖尿病大血管病变组FPG、HbA1c、FINS、LDL-C、HDL-C、chemerin、CRP水平及HOMA-IR、颈动脉内膜厚度比较,差异均有统计学意义(P<0.05);其中FPG、HbA1c、FINS、LDL-C、chemerin、CRP水平及HOMA-IR、颈动脉内膜厚度依次增加,而HDL-C水平依次降低,组间两两比较差异均有统计学意义(P<0.05)。(2)直线相关分析显示,血清chemerin、CRP水平均与收缩压、FPG、HbA1c、LDL-C、FINS、HOMA-IR、颈动脉内膜厚度呈正相关(P<0.05),与HDL-C呈负相关(P<0.05);HOMA-IR与BMI、收缩压、舒张压、颈动脉内膜厚度均呈正相关(P<0.05)。结论血清chemerin、CRP水平和IR升高可能与2型糖尿病患者发生大血管病变有关。

Objective To investigate the association of serum chemerin,CRP and IR with large vascular disease in type 2 diabetes mellitus（T2DM）.Methods 60 T2DM patients admitted to the Affiliated Hospital of Guilin Medical College from 2010 to 2011 were divided into T2DM alone group（30 cases） and macroangiopathy group（30 cases）.Another 30 healthy people were involved as the control group.ELISA and immunoturbidimetry were used to detect serum chemerin level and CRP level.Meanwhile,clinical features like height,weight,systolic pressure,diastolic pressure,FPG,HbA1c,FINS,LDL-C,HDL-C and carotid intima-media thickness were detected and BMI and HOMA-IR were calculated.Results（1） FPG,HbA1c,FINS,LDL-C,HDL-C,serum chemerin,CRP,HOMA-IR and carotid intima-media thickness showed statistically significant differences between control group,T2DM alone group and macroangiopathy group（P《0.05）,with the FPG,HbA1c,FINS,LDL-C,serum chemerin,CRP,HOMA-IR and carotid intima-media thickness were increased successively in the three groups,while the level of HDL-C was decreased successively,and the differences pairwise were statistically significant（P《0.05）.（2） Linear correlation analysis showed that serum chemerin and CRP were both positively correlated with systolic pressure,FPG,HbA1c,LDL-C,FINS,HOMA-IR and carotid intima-media thickness（P《0.05）,while negatively correlated with HDL-C（P《0.05）.The HOMA-IR was positively correlated with BMI,systolic pressure,diastolic pressure and carotid intima-media thickness（P《0.05）.Conclusion Serum chemerin,CRP and IR in T2DM patients are increased and the levels may be attributed to the development of macroangiopathy.