无血管病变的2型糖尿病患者循环晚期氧化蛋白产物水平与Framingham风险评分的关系

Association of plasma level of advanced oxidation protein products with Framingham risk score in type 2 diabetic patients without vascular diseases

目的研究无血管病变的2型糖尿病患者循环晚期氧化蛋白产物(AOPPs)水平与Framingham风险评分关系。方法采用横断面调查研究,于2010年3月~2011年5月在南方医科大学三所附属医院招募无血管病变的2型糖尿病患者为研究对象,以年龄、性别相匹配的正常健康人群为对照组,统计一般人口学指标,检测生化指标以及循环AOPPs水平,采用Framingham风险评分评估10年内发生心血管事件的风险。结果入组112例2型糖尿病患者,49例健康人群。2型糖尿病患者的体质量指数(BMI)、血糖、甘油三脂、低密度脂蛋白、循环AOPPs、Framingham风险评分显著高于正常人群,而高密度脂蛋白较正常人群显著降低;通过Spearman相关分析发现,AOPPs与Framingham风险评分呈显著正相关(r=0.44,P<0.001),进一步通过多元线性回归分析发现,AOPPs仍与Framingham风险评分呈显著正相关(β=0.305,P<0.001)。结论无血管病变的2型糖尿病患者循环AOPPs较正常人显著升高,且其发生心血管事件的风险评分显著高于正常人,而AOPPs与患者心血管事件发生风险评分呈独立的正相关关系,提示AOPPs的升高可能预示着2型糖尿病患者发生心血管事件的风险升高。

Objective To explore the association of plasma level of advanced oxidation protein products（AOPPs） with Framingham risk score in type 2 diabetic patients without vascular diseases. Methods This cross-sectional study was conducted among type 2 diabetic patients without vascular diseases recruited from 3 affiliated hospitals of Southern Medical University between March, 2010 and May, 2011, with age-and gender-matched healthy individuals as the control group. The demographic data were collected from all the participants, and the biochemical indexes and plasma levels of AOPPs were examined. The risk of cardiovascular disease in 10 years was assessed for all the participants based on their Framingham risk scores. Results A total of 112 diabetic patients and 49 healthy subjects were enrolled in this study. The diabetic patients had significantly higher body mass index（BMI）, blood glucose, triglyceride, low-density lipoprotein（LDL）, plasma AOPPs and Framingham risk score but lower high-density lipoprotein level than the control subjects. Spearman correlation analysis showed that plasma level of AOPPs was positively correlated with the Framingham risk score（r=-0.44, P0.001）, and further multiple linear regression analysis suggested that plasma AOPPs level was independently correlated with the Framingham risk score（β =0.305, P0.001）. Conclusion Type 2 diabetic patients without vascular diseases have significantly higher plasma levels of AOPPs and are at a greater risk of cardiovascular events in 10 years than healthy individuals. Plasma AOPPs are positively correlated with the Framingham risk score, suggesting the value of plasma AOPPs level in predicting the risk of cardiovascular events in these patients.