还原型凝血因子Ⅺ在老年2型糖尿病合并大血管病变患者血浆中的变化

Investigation of the change in redox state of plasma factor XI in elderly type 2 diabetic patients with macroangiopathy

目的探讨凝血因子Ⅺ（FXI）氧化还原状态在老年2型糖尿病患者（T2DM）高凝及大血管病变发病中的作用。方法测定老年T2DM患者及健康对照者血浆中还原型FXI的相对水平，并对与之相关的变量进行统计学分析。结果老年T2DM患者血浆还原型FXI相对水平均高于对照组，T2DM合并大血管并发症患者（DMAP组）血浆还原型FXI水平较无血管并发症患者（T2DM组）明显升高，分别为对照组（80．6±15．6）％，T2DM组（94．7±16．0）％，DMAP组（142．6±36．5）％（P〈0．05）。多元逐步回归分析显示，血浆三酰甘油、胆固醇和高密度脂蛋白胆固醇（HDL-C）是还原型FXI的独立预告因子。结论在T2DM合并大血管并发症的老年患者中血浆还原型FXI升高，血脂异常可能与还原型FXI的增加有关。

Objective To investigate the potential effect of the redox state of plasma factor XI （FXI） on the pathogenesis of elderly diabetic hypercoagulability and macroangiopathy. Methods The plasma levels of reduced FXI were detected in elderly type 2 diabetic（T2DM）patients with/ without macroangiopathy （T2DM group/DMAP group） and healthy subjects （control group）, and variables associated with reduced FXI were analyzed. Results Elderly patients with T2DM had higher plasma levels of reduced FXI as compared with healthy controls. The level of reduced FXI was significantly higher in patients with macroangiopathy than without macroangiopathy [control group： （80.6±15.6）%, T2DM group： （94.7±16.0）%, DMAP group （142.6±36.5）%, all P〈0. 05]. The multiple stepwise regression analysis showed that plasma levels of triglyceride, cholesterol and HDL-cholesterol were the independent predictors for reduced FXI. Conclusions The plasma level of reduced FXI is increased in elderly T2DM patients with macroangiopathy. The abnormality of lipid profiles may associate with the increment of reduced FXI. These findings maybe provide the novel mechanisms for diabetic hypercoagulability and macroangiopathy.