新诊2型糖尿病患者血浆视黄醇结合蛋白4与亚临床动脉粥样硬化的关系

The Relationship Between Plasma Retinol-binding Protein 4 and Subclinical Atherosclerosis in Newly Diagnosed Type 2 Diabetic Patients

目的探讨新诊2型糖尿病(T2DM)患者血浆视黄醇结合蛋白4(RBP4)与亚临床动脉粥样硬化(subAs)的关系。方法对217例新诊T2DM患者测定血浆RBP4浓度、空腹及餐后血糖、糖化血红蛋白、血脂、空腹胰岛素及颈总动脉内膜中膜厚度(IMT)、髂总动脉IMT、股动脉IMT,分析其subAs的发生情况。结果合并subAs的T2DM患者平均年龄、空腹胰岛素、血浆RBP4浓度均高于非subAs组患者(均P<0.05)。将患者按RBP4浓度三分位数分组,随RBP4浓度增加,患者颈总动脉IMT、髂总动脉IMT、股动脉IMT均增加,高浓度RBP4组患者的颈总动脉IMT高于其余两组(P<0.05);随RBP4浓度增加,subAs患病率也逐步升高,高浓度RBP4组患者的subAs患病率显著高于其余两组(P<0.05)。相关分析显示新诊T2DM患者RBP4浓度与颈总动脉IMT、髂总动脉IMT、体质指数、收缩压、血糖、空腹胰岛素呈正相关。多元逐步Logistic回归分析显示:新诊T2DM患者subAs的发生与血浆RBP4、年龄、低密度脂蛋白胆固醇显著相关。结论新诊T2DM患者血浆RBP4水平与subAs呈正相关关系,血浆RBP4升高可能是新诊T2DM患者subAs的独立危险因素之一。

Aim To evaluate the relationship between the concentration of plasma retinol-binding protein 4（ RBP4） and subclinical atherosclerosis（ subAs） in newly diagnosed type 2 diabetes mellitus（ T2DM） patients.Methods 217 newly diagnosed T2DM patients were selected.Plasma RBP4 concentration,fasting and postprandial blood glucose,glycosylated hemoglobin A1（ Hb A1c）,blood lipid,fasting insulin（ FINS） and common carotid artery intima-media thickness（ IMT）,common iliac artery IMT,femoral artery IMT were measured.The occurrence of subAs in patients was analyzed.Results The average age,FINS and plasma RBP4 concentration in T2DM patients with subAs were significantly higher than T2DM patients with non-subAs（ all P〈0.05）.The patients were divided into three groups based on the concentrations of RBP4.With the increase of RBP4 concentration,the common carotid artery IMT,common iliac artery IMT,femoral artery IMT were increased,and the common carotid artery IMT in high concentration RBP4 group was higher than that in the other two groups（ P〈0.05）.With the increase of RBP4 concentration,the prevalence of subAs was gradually increased,and the prevalence of subAs in high concentration RBP4 group was significantly higher than that in the other two groups（ P〈0.05）.Correlation analysis showed that the RBP4 concentration of newly diagnosed T2DM patients was positively correlated with common carotid artery IMT,common iliac artery IMT,body mass index,systolic blood pressure,blood glucose and FINS.Multiple stepwise Logistic regression analysis showed that the incidence of subAs in newly diagnosed T2DM patients was significantly correlated with the levels of plasma RBP4,age,and low density lipoprotein cholesterol.Conclusion Plasma RBP4 level is positively correlated with subAs,and plasma RBP4 elevation may be one of the independent risk factors of subAs in newly diagnosed T2DM patients.