2型糖尿病患者血清低氧诱导因子-1α与冠状动脉钙化之间的关系

Relationship between serum hypoxia-inducible factor 1α and coronary artery calcification in patients with uncomplicated type 2 diabetic

目的:明确在2型糖尿病患者中,血清低氧诱导因子(HIF-1)亚基HIF-1α水平和冠状动脉钙化(CAC)之间有无相关性。方法:共有405例无心血管疾病症状的2型糖尿病患者被纳入研究。使用ELISA方法测量血清HIF-1α、白细胞介素6(IL-6)水平。CAC积分由320CT进行扫描测定。根据血清HIF-1α水平将患者进行四分位数法分组。结果:血清HIF-1α平均水平为(184.4±66.7)pg/ml。在具有较高CAC积分的患者中,HIF-1α水平也显著增加(P<0.001)。HIF-1α水平与CRP、IL-6、UKPDS风险积分、HbA1c、FBG和CAC积分呈显著的正相关性,但与糖尿病持续时间、年龄、LDL不相关。多元逻辑回归分析显示,HIF-1α水平能独立预测CAC的存在。ROC曲线分析显示,HIF-1α水平能预测CAC的严重程度,但特异性低于传统的危险因素UKPDS风险积分和HbA1c。结论:作为低氧的标志物,血清HIF-1α水平可能是CAC存在的独立危险因素,升高的血清HIF-1α水平可能涉及2型糖尿病患者的血管钙化。

Objective：To determine the relationship of serum HIF-1α with coronary artery calcification （CAC） in patients with type 2 diabetes. Method：The subjects were 405 asymptomatic patients with type 2 diabetes melli- tus. Serum levels of HIF-1α and interleukin-6 （IL-6） were measured by ELISA. CAC scores were assessed by a 320-slice CT scanner. The subjects were divided into 4 quartiles depending on serum HIF-1α levels. Result： The average serum HIF-1α level was （184.4±66.7）pg/ml. Among patients with higher CAC scores, HIF-1α levels were also significantly increased （P〈0. 001）. HIF-1α levels positively correlated with CRP, IL-6, UKPDS risk score, HbA1c, FBG and CACS, but were not correlated with diabetes duration, age and LDL. According to mult- ivariate logic analyses, HIF-1α levels still significantly independent predicted the presence of CAC. Receiver-oper- ating characteristic curve analysis showed that serum HIF-1α level can predict the extent of CAC, but the specificity was lower than the traditional risk factors UKPDS and H bAlc. Conclusion：As a marker of hypoxia, serum HIF- 1α level may be an independent risk factor for presence of CAC. These findings indicate that elevated serum HIF- 1α may be involved in vascular calcification in patients with type 2 diabetes mellitus.