沿海地区初诊2型糖尿病患者治疗前后骨成型蛋白-4和凝血酶调节蛋白的变化及意义

Changes and significance of BMP-4 and TM in coastal area patients with newly diagnosed type 2 diabetes mellitus before and after therapy

目的：探讨沿海地区初诊2型糖尿病（T2DM）患者治疗前后骨成型蛋白-4（BMP-4）和凝血酶调节蛋白（TM）的变化及意义。方法采用ELISA方法检测42例正常人（正常对照组）和42例T2 DM患者BMP-4和TM水平及其他临床指标。结果 T2 DM患者治疗前BMP-4和TM水平明显高于对照组[（12．88±5．94）ng／L 和（5．17±3．07）ng／L，P＜0．01]、[（29．21±8．84）μg／L 和（15．90±6．19）μg／L，P＜0．01]；治疗12个月T2DM患者BMP-4和TM均有明显下降，但BMP-4在糖尿病达标组水平下降，与正常对照组无差别[（5．63±3．01）ng／L 和（5．17±3．07）ng／L，P＞0．05]，糖尿病未达标组BMP-4仍高于正常对照组[（8．91±2．68）ng／L 和（5．17±3．07）ng／L，P＜0．01]；TM在糖尿病达标组和未达标组均高于对照组，差异有统计学意义[（20．52±5．63）μg／L 和（15．90±6．19）μg／L，P＜0．01]、[（22．04±6．22）μg／L 和（15．90±6．19）μg／L，P＜0．05]。结论 BMP-4水平的改变与糖尿病患者血糖控制有关；而糖尿病患者高血糖、高血脂及其代谢调节因子对内皮细胞的损伤及活化没有随血糖、血脂的控制而立刻恢复，内皮损害的改善还需要时间。

Objective To investigate the changes and significance of BMP-4 and thrombomodulin （TM）in coastal area patients with newly diagnosed type 2 diabetes mellitus before and after therapy.Methods Plasma BMP-4 and TM levels,as well as other clinical indicators of 42 normal controls and 42 patients with T2DMwere detected by ELISA.Results BMP-4 and TMlevels in the patients with T2DMbefore therapy were significantly higher than those of the controls [（12.88 ±5.94）ng/L vs （5.17 ±3.07）ng/L and （29.21 ± 8.84）μg/L vs （15.90 ±6.19）μg/L,（P＆gt;0.05）].After 12 months of therapy,BMP-4 and TMlevels were all significantly decreased in the patients with T2DM,but the levels of BMP-4 were decreased in the patients who reached the normal level,and there were no differences in them,when they were compared with those of the controls [（5.63 ±3.01）ng/L vs （5.17 ±3.07）ng/L,（P＆gt;0.05）].BMP-4 level in the patients who failed to reach the normal level was still higher than that of the controls [（8.91 ±2.68）ng/L vs （5.17 ± 3.07）ng/L,P〈0.01].The levels of TM both in patients who reached the normal level were all higher than those of the controls （20.52 ±5.63 vs 15.90 ±6.19,P〈0.01）,（22.04 ±6.22 vs 15.90 ±6.19,P〈0.05）.Conclusions Changes in BMP-4 levels were associated with the blood glucose control of the DM patients.The high levels of blood glucose,blood lipid and the activation and damage to endothelial cells in the DM patients failed to recover to normal levels with the control of blood glucose and blood lipid.It might take time to improve the function of endothelial cells.