血清Chemerin及TNF-α对2型糖尿病大血管病变的影响

The impact of chemerin and tumor necrosis factor-α in type 2 diabetes with macrowasculor complications

目的检测2型糖尿病有无大血管病变患者血清Chemerin及TNF-α水平,探讨Chemerin、TNF-α对T2DM合并大血管病变的影响。方法选取2型糖尿病60例,按有无大血管病变分为2型糖尿病合并大血管病变组30例,2型糖尿病无大血管病变组30例。选取同期非糖尿病的健康者25例作为对照组。分别测量身高、体重、肝功、血脂、空腹血糖、空腹血清胰岛素、糖化血红蛋白(Hb A1C)、Chemerin及TNF-ɑ水平,计算体重指数(BMI)及胰岛素抵抗指数(HOMA-IR)。进行相关分析及逐步回归分析。结果健康对照组、T2DM无大血管病变组、T2DM有大血管病变组Chemerin、TNF-α水平依次升高,线性相关分析显示血清Chemerin、TNF-α与BMI、TG、Hb A1C、FBG、HOMA-IR呈正相关。BMI与HOMA-IR呈正相关;多元逐步回归分析表明,Chemerin、TNF-α分别与BMI、HOMA-IR独立相关。结论血清Chemerin、TNF-α与2型糖尿病胰岛素抵抗关系密切,而胰岛素抵抗增加心脑血管病变的风险。T2DM大血管病变组Chemerin、TNF-α水平较T2DM无大血管病变组高。Chemerin、TNF-α是2型糖尿病合并大血管病变的重要影响因子,对抗动脉硬化、改善胰岛素抵抗等方面有益,可能成为治疗2型糖尿病合并大血管病变提供新思路。

Objective To detect the plasma level of chemerin,necrosisi factor -α （TNF -α） in type 2 diabetes with macro- vascular complications and without macrovascular complications, explore the effect of chemerin ,TNF - α in type 2 diabetes with macro- vascular complications. Methods Selected 30 cases of type 2 diabetes with macrovascular complications as group A,30 patients of 2 diabetes without macrovascular complications as group B, and in the same time 25 persons as control group. Height, weight bloodlipids, glocosylated hemoglobin（HbA1C） ,fasting plasma glucose（FPG） ,fasting insulin（FINS）. Plasma chemerin and TNF level were measured ELISA. Calculation of body mass index（BMI） and insulin resistance index（ HOMA- IR）. Correlationg analysis and stepwise regression analysis. Results plasma chemerin ,TNF -α of patients were significantly higher than that of the control group（ P 〈 0.05 ）, especially in groups with macrovascular complications. Conclusion The level of plasma chemerin,TNF - α in the T2DM patients is increased, and the levels may be attributed to the oatients with macrovascular complications.