2型糖尿病患者血清抵抗素、瘦素、脂联素水平与外周动脉弹性及舒张功能的相关性研究

Correlation study on serum levels of resistin,adiponectin,leptin to peripheral artery elasticity and diastolic function in patients with type-2 diabetes mellitus

目的探讨2型糖尿病患者血清抵抗素、瘦素、脂联素水平与颈动脉弹性指标及肱动脉血管舒张功能的相关性。方法选取2014年12月至2015年8月收治的2型糖尿病(T2DM)患者60例(T2DM组)、糖耐量异常(IGT)患者50例(IGT组)和体检健康者50例(NC组),采用酶联免疫吸附试验(ELISA)检测其血清抵抗素、瘦素、脂联素水平;同时应用回声跟踪技术(ET)检测颈动脉压力应变弹性系数(Ep)、动脉顺应性(AC)、硬化参数(β)、脉搏波传导速度(PWVβ)、管径增大指数(AI);并测量肱动脉内径变化率,变化率小于4%定义为非内皮依赖性血管舒张功能(EID)受损。结果 NC组、IGT组、T2DM组血清抵抗素、瘦素水平、Ep、β、AI、PWVβ值及EID受损率依次增高,脂联素水平及AC则逐步降低,各组间比较差异均有统计学意义(P<0.01);T2DM患者血清抵抗素、瘦素水平与β、PWVβ及EID受损率呈正相关,而脂联素水平则与β、PWVβ及EID受损率呈负相关(P<0.05);T2DM患者血清抵抗素、瘦素水平均与脂联素呈负相关(均P=0.000)。结论 T2DM患者血清抵抗素、瘦素、脂联素水平与颈动脉β、PWVβ、EID受损有明显相关性,三者均是早期发现外周动脉弹性和舒张功能病变的敏感指标。

Objective To explore the correlations of serum levels of resistin,adiponectin and leptin to carotid artery elasticity indexes and brachial artery diastolic function in patients with type-2 diabetes mellitus（T2DM）. Methods A total of 60 cases of patients with T2DM（T2DM group）, 50 cases of patients with impaired glucose tolerance（IGT, IGT group） and 50 healthy individuals （NC group） were selected from December 2014 to August 2015. The serum levels of resistin, adiponectin and leptin were detected by using ELISA. The carotid artery elasticity indexes, including pressure-strain elastic modulus（Ep）, stiffness parameter（t） , arterial compliance（AC） ,augmentation index（AI） and pulse wave velocity β（PWVβ）, were measured by using echo-tracking（ET） technique. Changes in brachial artery diameter were also detected,and the patient was defined as damage to endothelium-independented diation（EID） when the rate of change was less than 4%. Results The serum levels of resistin and leptin,values of Ep,β,AI and PWVβ,and the rate of EID damage in the NC group,IGT group and T2DM group were increased in turn,while the serum level of adiponectin and the value of AC in the NC group,IGT group and T2DM group were decreased in turn,there were statistically significant differences in these indexes between each group（P〈0.01）. For patients with T2DM, the serum levels of resistin and leptin were positively related to the values ofβ,PWVβ and the rate of EID damage, while the serum level of adiponectin was negatively related to the values of β,PWVβ and the rate of EID damage（P〈0.05）. For patients with T2DM,the serum levels of resistin and leptin were both negatively related to the serum level of adiponectin（P= 0. 000）. Conclusion The serum levels of resistin,adiponectin and leptin have obvious correlations with 13,PWVI3 and EID damage, which could be sensitive indexes for early detecting artery elasticity and lesions in diastolic function.