瑞舒伐他汀对冠心病合并2型糖尿病患者血浆Omentin-1的影响

Effects of rosuvastatin on plasma omentin-1 levels in coronary heart disease patients with type 2 diabetes mellitus

目的探讨冠心病(CHD)合并2型糖尿病(T2DM)患者血浆网膜素-1(Omentin-1)水平的变化及瑞舒伐他汀治疗对Omentin-1水平的影响。方法选择临床确诊的住院和门诊单纯T2DM患者42例和CHD合并T2DM患者47例。同期选择健康体检者37例作为正常对照组(NC组)。采用ELISA法测定所有研究对象及CHD合并T2DM组瑞舒伐他汀治疗后血浆Omentin-1水平,并分析血浆Omentin-1水平与白细胞介素6(IL-6)、空腹胰岛素(FINS)、体重指数(BMI)、内皮素(ET)、胰岛素抵抗指数(HOMA-IR)和一氧化氮(NO)等的关系。结果与NC组(24.79±6.18ng/ml)比较,CHD合并T2DM组治疗前(14.75±4.02 ng/ml)和单纯T2DM组(19.32±5.17 ng/ml)患者血浆Omentin-1水平均明显降低(P均<0.01),CHD合并T2DM组治疗前血浆Omentin-1水平显著低于单纯T2DM组(14.75±4.02vs.18.30±5.17 ng/ml,P<0.01)。CHD合并T2DM患者血浆Omentin-1水平与FINS、BMI、HOMA-IR、IL-6、ET呈明显负相关,与NO呈正相关(P<0.01或P<0.05)。HOMA-IR、IL-6和NO是影响CHD合并T2DM患者血浆Omentin-1水平的独立相关因素。CHD合并T2DM患者经瑞舒伐他汀治疗后TC、LDL-C、IL-6和ET均显著降低,而HDL-C和NO则显著增高(P<0.05),同时血浆Omentin-1水平也明显升高(18.35±3.97 vs.14.75±4.02 ng/ml,P<0.01)。结论瑞舒伐他汀在有效调节CHD合并T2DM患者脂代谢,减轻炎症反应,改善内皮功能的同时,升高血浆Omentin-1水平。

Objective To explore the effects of rosuvastatin on plasma omentin - 1 levels in coronary heart disease （CHD） patients with type 2 diabetes mellitus （T2DM）. Methods Forty -two patients with uncomplicated T2DM, 47 CHD patients accompanied with T2DM and 37 subjects with normal control （NC） participated in this study. The relationship between plasma omentin - 1 levels and interleukin - 6 （ IL - 6 ）, body mass index （ BMI）, endothelin （ ET）, HOMA - insulin resistance index （ HOMA - IR）, nitric oxide （NO） was analyzed. After rosuvastatin treatment, plasma omentin - 1 levels were observed in CHD patients with T2DM. Results Patients with T2DM and CHD patients complicated by T2DM before the treatment had significantly lower plasma omentin - 1 levels than that of NC group （ 19.32 ± 5.17 vs. 24.79 ± 6.18 ng/ml and 14.75 ± 4.02 vs. 24.79 ± 6.18 ng/ml, respectively, all P 〈 0.01 ）. CHD patients complicated by T2DM before the treatment had significantly lower plasma omentin - I levels than that of T2DM group （ 14.75 ± 4.02 vs. 18.30 ± 5.17 ng/ml, P 〈 0.01 ）. Plasma omentin - 1 levels were negatively correlated with fasting insulin （ Fins）, BM1, HOMA - IR, IL - 6 and ET and positively correlated with NO （ P 〈 0.01 or P 〈 0.05 ）. HOMA - IR, IL - 6 and NO were the independent risk factors of plasma omentin - 1 in CHD patients complicated by T2DM. After rosuvastatin treatment, total cholesterol （ TC）, low - density lipopretein cholesterol （ LDL - C）, IL - 6 and ET were significantly decreased, and high - densi- ty lipoprotein cholesterol （HDL -C） and NO levels were significantly increased （ P 〈 0.05 ） in CHD patients complicated by T2DM. Moreover, plasma omentin - 1 levels were also significantly increased （ 18.35 ± 3.97 vs. 14.75 ± 4.02 ng/ml, P 〈 0.01 ）. Conclusion Rosuvastatin can remarkably regulate lipid metabolism, reduce inflammatory reaction, improve endothelial function as well as elevate plasma omentin - 1 levels in CHD patients complicated by T2DM.