2型糖尿病微血管病变患者血清血小板反应蛋白-1水平的变化及临床意义

Research of serum thrombospondin 1 levels in T2DM patients with microangiopathy complications

目的探讨T2DM微血管病变与血清血小板反应蛋白-1(TSP-1)的相关性。方法将176例研究对象分为糖尿病合并微血管病变组(A,n=58)、未合并微血管病变组(B,n=64)与正常对照组(C,n=54),检测研究对象血清TSP-1水平及相关临床指标,并计算胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)。结果 A、B组血清TSP-1水平均高于C组(P<0.05),A组血清TSP-1水平高于B组(P<0.05)。相关分析显示,血清TSP-1水平与FPG、HbA1c、hsC-RP呈正相关(P<0.01),与HOMA-β及FIns呈负相关(P<0.01)。多元线性逐步回归分析显示,HbA1c、FPG、HOMA-β及FIns是血清TSP-1水平的独立影响因素(P<0.05)。结论 TSP-1在T2DM微血管病变患者血清中表达升高,其可能参与糖尿病微血管病变病理生理过程,检测血清TSP-1的水平对预测糖尿病微血管病变有一定的价值。

Objective To explore the relationship of serum thrombospondin -1 （TSP-1） in T2DM patients with microangiopathy complications in T2DM patients . Methods A total of 176 cases were divided into 3 groups： T2DM patients with microangiopathy complications group （group A, 58 cases） , T2DM patientsand without microangiopathy complications group （group B, 64 cases） microangiopathy complications and normal controls group（group C, 54 cases）.The serum TSP-1 and other clinical indicators of all the cases were detected .Use The steady -state model was used to account for the indexes of insulin resistance （HOMA- IR） and islet beta cell function index （HOMA-β）. Results The serum TSP-1 levels in type 2 diabetes with and without microangiopathy complications were significantly higher in group A and B than those in control group C（P〈0.05）. Furthermore, among type 2 diabetes,serum TSP-1 level was higher in patients with microangiopathygroup A than those withoutin group B（P〈0.05）. AThe multivariate correlation analysis showed that serum TSP-1 level positively correlates with FBGG, 、HbA1c、hs-C-RP（P〈0.01）,while negatively with HOMA-βand FINSns（P〈0.01）. Stepwise linear multiple regression revealed that HbA1Cc、FBG、HOMA-βand FINSns （P〈0.05）were the independent factors of serum TSP-1 level（P〈0.05）. Conclusion The serum TSP-1 levels is elevated in T2DM patients with microangiopathy,suggesting that it might play a role in the pathophysiology of diabetic microangiopathy,.The serum TSP-1 has and it is significant value in predicting the microangiopathy of theseT2DM patients.