MIF水平与冠心病合并糖尿病的关系及其临床意义

Relationship between Macrophage Migration Inhibitory Factor and Coronary Heart Disease with Diabetes Mellitus and Its Clinical Significance

目的探讨巨噬细胞移动抑制因子(MIF)水平与冠心病(CHD)合并糖尿病(DM)的关系及其临床意义。方法选择2012年11月—2015年2月我院心血管内科的住院病人117例,分为3组:冠心病组(CHD组)59例,冠心病+糖尿病组(CHD+DM组)58例,服用DPP-4抑制剂(沙格列汀)2个月后冠心病+糖尿病组(CHD+DM+DPP-4组)58例。检测各组血清MIF、糖化血红蛋白(HbA 1c)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、尿素氮(BUN)和肌酐(Cr),计算体重指数(BMI),并作相关性分析。结果 CHD+DM组病人HbA 1c和MIF水平明显高于CHD组和CHD+DM+DPP-4组,差异有统计学意义(P<0.05);CHD+DM+DPP-4组病人的MIF水平较CHD+DM组显著降低,差异有统计学意义(P<0.01);CHD+DM组和CHD+DM+DPP-4组病人的MIF水平与HbA 1c、TG、TC及LDL水平呈显著正相关(P<0.05)。结论冠心病合并糖尿病病人体内MIF异常表达明显,其与HbA lc、TG、TC及LDL水平呈显著正相关,在冠心病合并糖尿病的病理改变过程中具有重要意义;DPP-4抑制剂不仅能降低冠心病合并糖尿病病人的血糖水平,还能调节血脂代谢,降低血清中MIF水平,进而发挥抗炎作用,改善冠心病动脉粥样硬化的发生及发展进程。

Objective To explore the relationship between macrophage migration inhibitory factor （MIF） and coronary heart disease （CHD） with diabetes mellitus （DM） and its clinical significance. Methods One hundred and seventeen patients with cardiovascular diseases in our hospital from Nov 2012 to Feb 2015 were divided into 3 groups： CHD group （ n = 59 ）,CHD ＋ DM group （ n = 58）, CHD＋DM ＋ DPP 4 group （patients with CHD and DM who taking DPP 4 inhibitors （Saxagliptin） for 2 months,n= 58）. The ser-um MIF,glycosylated hemoglobin （HbA1c）,hree glycerol （TG）,otal cholesterol （TC） .high density lipoprotein cholesterol （HDL- C）, low density lipoprotein cholesterol （LDL C）,alanine aminotransferase （ALT）,aspartate aminotransferase （AST）,urea nitrogen （BUN）, creatinine （Cr）, body mass index （BMI） were tested in the 3 groups and their correlation were analyzed also. Results The level of HbA1c and MIF in CHD ＋ DM group were higher than those in CHD group and CHD ＋ DM ＋ DPP 4 group , and the difference were statistically significant （ P 〈0.05）. The level of MIF in CHD ＋ DM ＋ DPP 4 group was lower than that in the CHD ＋ DM group, and the difference was statistically significant （ P 〈0.01）. The level of MIF in CHD＋ DM＋ DPP 4 group and CHD ＋ DM group were positively correlated with HbAlc, TG,TC and LDL （ P 〈.05）. Conclusion The expression of MIF in patients with CHD and HD were obviously abnormal , and the expression were positively correlated with HbAlc , TG , TC and LDL , which had a great significance in the pathological changes of coronary heart disease with diabetes mellitus. DPP 4 inhibitors could not only reduce blood sugar levels and regulate lipid metabolism for patients with CHD and HD , but also reduce the level of serum MIF and have anti inflammatory effect, which could improve the occurrence and development of atherosclerosis in coronary heart disease.