血浆可溶性CD36与2型糖尿病及亚临床大血管病变的关系

Association of soluble CD36 with type 2 diabetes mellitus and subclinical macrovascular disease

目的 比较糖耐量正常人群、2型糖尿病及亚临床大血管病变患者血浆可溶性CD36（sCD36）的水平.方法 收集2型糖尿病患者196例及社区糖耐量正常人群135例,根据颈动脉超声分为糖尿病合并亚临床大血管病变组（SMDM组,118例）、单纯糖尿病组（DM组,78例）、亚临床大血管病变组（SMD组,42例）和对照组（NC组,93例）,比较4组sCD36水平及其他临床和理化参数.结果 SM组、DM组及SMDM组的sCD36水平显著高于NC组（P＜0.05）,糖尿病与亚临床大血管病变对sCD36水平有正交互作用（F =5.741,P＜0.05）.Logistic回归显示,血浆sCD36是单纯亚临床大血管病变（OR =2.444,95％ CI：1.449 ～4.125,P=0.001）及糖尿病患者合并亚临床大血管病变（OR=1.248,95％ CI：1.038～1.499,P=0.018）和发生2型糖尿病的危险因素（OR=1.206,95％ CI：1.026～1.418,P=0.024）.结论 血浆sCD36水平可能是2型糖尿病与亚临床大血管病变的风险标志物.

Objective To compare the levels of plasma soluble CD36 in individuals with normal glucose tolerance,type 2 diabetes,and subclinical macrovascular disease. Methods According to results of B mode ultrasound,196 cases of type 2 diabetic patients and 135 individuals with normal glucose tolerance were divided into diabetes with subclinical macrovascular diseases （ SMDM, n = 118 ）, diabetic group （ DM, n = 78 ）, subclinical macrovascular diseases（ SMD, n = 42） and normal control group（ NC, n = 93 ）. Levels of sCD36 and other clinical characteristics were compared among four groups. Results Plasma sCD3s was high- er in SMD group,DM group and SMDM group than in control group（P 〈0.05）. There were positive interac- tions between type 2 diabetes and subclinical macrovascular disease on levels of sCD36 （F = 5. 741, P 〈0.05）. Plasma sCD36 was risk predictor of subclinical macrovascular disease （OR = 2. 444,95% CI 1. 449-4. 125 ,P = 0. 001 ）, diabetic patients with subclinical macrovascular disease （ OR = 1. 248,95% CI 1. 038-1. 499, P = 0.018 ） and type 2 diabetes （ OR = 1. 206,95 % CI 1. 026-1.418, P = 0.024 ）. Conclusion P]asma sCD36 may be a risk marker of both type 2 diabetes and subclinical macrovascular disease.