脂肪细胞因子在2型糖尿病并发大血管病变中的意义

Significance of serum adiponectin and retinol binding protein 4 levels in type 2 diabetes complicated with macrovascular lesion

目的:探讨血清脂联素(APN)及视黄醇结合蛋白4(RBP4)水平在2型糖尿病(T2DM)大血管病变中的变化及意义。方法:选取T2DM并发大血管病变者36例(Ⅰ组)、单纯T2DM者38例(Ⅱ组)和健康体检者32例(Ⅲ组),采用ELISA法检测其血清标本的APN和RBP4浓度,同时检测血糖血脂及糖化血红蛋白(HbA1c)浓度。结果:Ⅰ组血清APN的浓度为(3.5±0.8)mg/L,显著低于Ⅱ组(7.8±0.9)mg/L和Ⅲ组(11.6±1.6)mg/L;Ⅰ组血清RBP4浓度为(23.1±2.8)mg/L,显著高于Ⅱ组(13.6±1.5)mg/L和Ⅲ组(10.2±1.7)mg/L。APN浓度与空腹血糖、甘油三酯、低密度脂蛋白胆固醇和HbA1c水平呈负相关(r=-0.402、-0.322、-0.316、-0.518和-0.469,均P<0.05);而RBP4与上述指标呈正相关(r=0.486、0.347、0.396、0.401和0.355,均P<0.05),与高密度脂蛋白胆固醇呈负相关(r=-0.426,P<0.05)。结论:血清ANP和RBP4检测对T2DM大血管病变具有重要的预测价值。

Objective： To investigate the changes of serum adiponectin （APN） and retinol-binding protein 4 （RBP4） levels and their clinical significance in type 2 diabetes mellitus （T2DM） with large blood vessel lesion. Method：Serum concentrations of APN and RBP4 of 36 T2DM patients with macroangiopathy （group Ⅰ ）, 38 patients with T2DM alone（group Ⅱ ） and 32 healthy individuals （groupⅢ） were measured using ELISA. Blood glucose, lipids and glycosylated hemoglobin （HbAlc） levels were also detected. Result：Serum APN concentration of group Ⅰ was （3.5± 0.8） mg/ L, which was significantly lower than that of group Ⅱ （7.8± 0.9）mg / L and group Ⅲ （11.6＋ 1.6）mg / L. Serum RBP4 level of group Ⅰ was （23.1± 2.8）mg / L, which was significantly higher than that of group Ⅱ （13.6± 1.5）mg/L and group Ⅲ （10.2±1.7）mg/L. Statistic analysis revealed that the level of APN was negatively correlated with the levels of GLU, TG, LDL-C and HbAlc （r=-0.402, -0. 322,-0. 316,-0. 518 and -0. 469, respectively, all P〈0. 05） ; whereas the level of RBP4 showed positive association with these indices（r=0. 486,0. 347,0. 396,0. 401 and 0. 355, respectively, all P〈0.05） ,but negative correlation with HDL-C levels （r = - 0. 426, P〈0.05）. Conclusion： The detection of serum ANP and RBP4 levels may be important predictive value for T2DM patients with vascular disease.