血清YKL-40浓度与2型糖尿病大血管病变的相关性研究

Association between YKL-40 and type 2 diabetic microangiopathy

目的探讨血清几丁质酶-3样蛋白-1(YKL-40)与2型糖尿病大血管病变的关联。方法选择2型糖尿病患者420例,根据有无大血管病变分为两组,另选健康体检者210例作为对照。采用酶联免疫吸附法检测各组血清YKL-40水平,并检测糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)等。结果 2型糖尿病组YKL-40明显高于对照组,2型糖尿病合并大血管病变组明显高于单纯2型糖尿病组(P<0.05);2型糖尿病患者的YKL-40与腰臀比(WHR)、胰岛素抵抗指数(HOMR-IR)、FINS、Hb A1c、IL-6、TNF-α呈正相关(r值分别为0.466、0.423、0.375、0.492、0.578、0.635,均P<0.05)。结论 YKL-40与2型糖尿病大血管病变的发生、发展有着密切关系,血清YKL-40检测对2型糖尿病大血管病变的早期预测有重要意义。

Objective To study the association between chitinase-3-like-1 protein （YKL-40） in serum and type 2 diabetic microangiopathy.Methods A total of 420 type 2 diabetic patients were divided into two groups, with microangiopathy （group A）, and without microangiopathy （group B）. And, 210 healthy subjects were chosen as control group （group C）. The levels of YKL-40 were detected by enzyme linked immunosorbent assay, and the levels of glycosylated hemoglobin （HbA1c）, fasting insulin （FINS）, fasting blood-glucose （FPG）, triglyceride （TG）, total cholesterol （TC）, low density lipoprotein cholesterin （LDL-C）, high density lipoprotein cholesterol （HDL-C）, interleukin 6 （IL-6）, tumor necrosis factor-alpha （TNF-α） were detected, too.Results The levels of YKL-40 in group A and B were higher than that in group C （P〈0.05）, and the level of YKL-40 in group A was higher than that in group B （P〈0.05）. The YKL-40 level in serum of type 2 diabetic patients was positively correlated with waist hip rate （WHR）, insulin resistance index （HOMR-IR）, FINS, HbA1c, IL-6, and TNF-α （the values ofr were respectively 0.466, 0.423, 0.375, 0.492, 0.578, and 0.635,P〈0.05）.Conclusion YKL-40 is closely associated with the beginning and development of type 2 diabetic microangiopathy, and the detection of YKL-40 in serum is significant for early prediction of type 2 diabetic microangiopathy.