巨噬细胞移动抑制因子与2型糖尿病合并大血管病的关系研究

Association between serum macrophage migration inhibitory factor and macroangiopathy in patients with type 2 diabetes mellitus

目的探讨巨噬细胞移动抑制因子(MIF)与2型糖尿病(DM)并发大血管病的关系。方法 2型DM患者126例按是否发生大血管病变分为A组(n=65,发生血管病变者)和B组(n=61,未发生血管病变者),同期入选体检正常者60例为作为健康对照组(C组)。采用高分辨超声检测186例入选者的颈动脉内膜中层厚度(IMT),并进行MIF、空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、三酰甘油(TG)的实验室检查。结果 A、B 2组的各项监测结果(除HDL-C)均高于C组;A组的MIF、IMT、HbA_(1c)、LDL-C、TG水平均高于B组,HDL-C低于B组,且差异有统计学意义(P<0.05,P<0.01);A组颈动脉轻度狭窄22例(33.85%),中度32例(49.23%),重度11例(16.92%);患者MIF水平与IMT(r=0.977)、FPG(r=0.551)、HbA_(1c)(r=0.909)、LDLC(r=0.779)、TG(r=0.615)呈正相关性(均P<0.01),与HDL-C水平呈负相关(r=-0.516,P<0.01)。结论2型DM患者血浆MIF水平明显升高;发生血管病变的2型DM患者MIF水平与血管病变程度关系密切,且与血糖、血脂相关;2型DM患者进行MIF水平监测对防控大血管病变具有较高价值。

Objective To investigate the relationship between the expression of macrophage migration inhibitory lactor（MIF） and type 2 diabetes mellitus（DM） complicated with macrovascular disease.Methods According to with or without occurrence of major vascular lesions,type 2 DM patients（126 cases） were divided into group A（n =65,vascular lesions） and group B（n =61,there was no vascular lesions）.60 healthy subject over the same period were selected as the healthy control group（group C）.Using the high-resolution ultrasound to detect the carotid artery intima-media thickness（IMT）,MIF.fasting blood glucose（FPG）.glycosylated hemoglobin（HbA1c）.low density lipoprotein cholesterol（LDLC）.high density lipoprotein cholesterol（HDL-C）,triglycerol（TG） were detected by laboratory examination in these 186 cases of the participants.Results Group A and B＇s monitoring results（except HDL-C） were higher than those in group C;group A＇s MIF,IMT,HbA1c,LDL-C and TG levels were higher than in the group B,HDL-C were lower than in group B.and the difference had statistical significance（P〈0.05,P〈0.01）;carotid artery mild stenosis were 22 cases In group A（33.85%）,moderate of 32 cases（49.23%）,11 cases of severe（16.92%）;the level of MIF was posilively correlated with IMT（r =0.977）,FPG（r =0.551）,HbA1c（r =0.909）,LDL C（r =0.779）.TG（r =0.615）（all P〈0.01）.and negatively correlated with HDL-C levels（r =-0.516.P〈0.01）.Conclusion The MIF level in type 2 DM patients increased significantly;type 2 DM patients with vascular lesions,their MIF level was closely related of the degree of vascular lesions,and correlated with blood glucose and blood lipid;monitoring the level of MIF in patients with type 2 DM has a higher value for the prevention and control of large vascular disease.