2型糖尿病患者血清Vaspin水平与下肢血管病变严重程度的关系

Serum vaspin levels in type 2 diabetic patients are associated with the severity of lower limb vascular lesion

目的 探讨2型糖尿病（T2DM）患者血清腹腔脂肪型丝氨酸蛋白酶抑制剂（Vaspin）水平与下肢血管病变严重程度的关系.方法 选择T2DM患者92例,根据下肢血管内膜中层厚度、动脉斑块和狭窄程度评分,按照评分结果分为单纯糖尿病组（DM1组）（32例）、糖尿病合并轻度下肢血管病变组（Dm^2组）（33例）、糖尿病合并中重度下肢血管病变组（Dm^3组）（27例）.另外选择健康查体者26例作对照组.测定收缩压（SBP）、血脂、踝肱指数（ABI）、胰岛素抵抗指数（HOMA-IR）及血清Vaspin水平.结果 校正年龄、性别后,DM1组的血清Vaspin水平显著高于对照组,而Dm^2组和Dm^3组血清Vaspin水平低于DM1组,差异有统计学意义（P均＜0.01）.偏相关分析显示,血清Vaspin与HOMA-IR呈负相关（r=-0.461,P=0.001）,与ABI正相关（r=0.462,P=0.001）.Logistic回归分析显示,SBP、ABI和Vaspin水平是糖尿病发生下肢血管病变的独立危险因素.结论 血清Vaspin水平降低可能与T2DM患者下肢血管病变有关。

Objective To explore the association between serum vaspin levels and the severity of the lower extremity vascular lesions in type 2 diabetes mellitus （T2DM） patients.Methods According to the lower extremity artery plaque,stenosis and intima-media membrane thickening severity score,92 cases of T2DM patients were divided into three groups：simple diabetes group （DM1 group） （32 cases）,mild diabetic lower limb vascular lesion group （Dm^2 group） （33 cases）,and moderately severe diabetic lower limb vascular lesion group （Dm^3 group） （27 cases）.Twenty-six age-and gender-matched apparently healthy controls （control group） were recruited as well.Systolic blood pressure （SBP）,ankle-brachial index （ABI）,insulin resistance index （HOMA-IR）,and other indicators were determined,serum vaspin was measured by enzyme-linked immunosorbent assay.Results After adjustment for age and gender,the DM1 group had a significantly higher serum vaspin level than control group （P 〈0.01）,while for the Dm^2 and Dm^3 groups,serum vaspin levels were significantly lower than the DM1 group （P 〈 0.01）.Partial correlation analysis showed that serum vaspin was inversely associated with HOMA-IR （r =-0.461,P =0.001）and positively correlated with ABI （r =0.462,P =0.001）.Logistic regression analysis demonstrated that SBP,ABI and fasting serum vaspin levels were significantly associated with the presence of the lower extremity vascular lesions in type 2 diabetes.Conclusions Serum vaspin levels were significantly elevated in simple type 2 diabetic patients while the reduction of its level might be associated with the formation of lower extremity vascular lesions in type 2 diabetic patients.