不同糖耐量人群血清HSP70水平及其相关因素分析

Analysis of Serum HSP70 Level and Related Factors in Populations with Different Glucose Tolerance

目的检测不同糖耐量人群中空腹血清热激蛋白70(HSP70)水平的变化,探讨HSP70在2型糖尿病发生、发展中的可能作用。方法选取2012年9月至12月在南京市第一医院就诊并行口服葡萄糖耐量试验的患者152例,根据世界卫生组织(WHO)1999年糖尿病诊断标准,分为2型糖尿病(T2DM组)67例、糖调节受损(IGR组)32例和正常糖调节(NGR组)53例,检测各组血压、血糖、血脂、空腹胰岛素(FINS)和HSP70等指标,计算体质量指数(BMI)、腰臀比、体内脂肪含量(BF%)和胰岛素抵抗指数(HOMA-IR),分析HSP70与相关代谢指标的关系。结果T2DM组血清HSP70水平显著低于IGR组[(535.98±144.69)ng/L vs(623.20±146.99)ng/L,P<0.05)],IGR组血清HSP70水平显著低于NGR组[(623.20±146.99)ng/L vs(722.08±246.24)ng/L,P<0.05];血清HSP70水平与BMI、BF%、腰围、收缩压、舒张压、空腹血糖、口服葡萄糖耐量试验2 h血糖、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、胰岛素抵抗指数呈负相关(均P<0.01),与高密度脂蛋白胆固醇呈正相关(P<0.01);低密度脂蛋白胆固醇是血清HSP70的独立相关因素。结论血清HSP70水平随着糖耐量水平的升高逐渐降低,且与血压、血脂、体脂等指标相关,提示血清HSP70水平的变化可能与2型糖尿病的发病机制有关。

Objective To assay changes of serum heat shock protein 70（ HSP70） level in populations with different glucose tolerance,in order to explore the possible role of HSP70 in the occurrence of T2 DM. Methods A total of 152 subjects from Nanjing First Hospital during September and December of 2012 were selected and divided into three groups： type 2 diabetes mellitus（ T2 DM,67cases）,impaired glucose regulation（ IGR,32 cases）,normal glucose regulation（ NGR,53 cases）. The level of blood pressure,blood glucose,blood fat and fasting insulin（ FINS） and HSP70 of each group were measured and BMI,waist-hip ratio,body fat proportion（ BF%） and insulin resistance index（ HOMA-IR） were calculated,and the correlation between HSP70 and related metabolic indexes was analyzed. Results The serum HSP70 level in T2 DM group was significantly lower than that of IGR group[（ 535. 98 ± 144. 69 vs 623. 2 ± 146. 99） ng / L,P〈 0. 05） ],and HSP70 level of IGR group was significantly lower than NGR group[（ 623. 2 ± 146. 99 vs 722. 08 ± 246. 24） ng / L,P〈 0. 05].Correlation analysis showed that the serum HSP70 was negatively correlated to BMI,BF%,WC,SBP,DBP,FPG,2h PG,TG,TC,LDL-C,HOMA-IR（ P〈 0. 01）,and positively correlated to HDL-C（ P〈 0. 01）. LDL-C was an independent factor related to HSP70. Conclusion Serum HSP70 level decreases with the glucose tolerance increase,and is correlated with blood pressure,blood lipid and body fat,which indicates that serum HSP70 level changes might be correlated with the pathogenesis of type 2diabetes.