2型糖尿病患者血清Betatrophin水平变化对颈动脉内膜-中层厚度的影响

Change in levels of serum betatrophin and its effect on carotid intima-media thickness in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者血清Betatrophin水平变化对颈动脉内膜-中层厚度(CIMT)的影响。方法选取T2DM患者200例,其中T2DM合并CIMT增厚(CIMT≥1.0 mm,CIMT增厚组)与CIMT正常(CIMT<1.0 mm,CIMT正常组)的患者各100例,采用ELISA法检测受试者血清Betatrophin浓度,同时测量血糖、血脂、空腹胰岛素(FINS)等相关生化指标。采用Pearson相关进行相关分析,多元逐步回归分析CIMT增厚影响因素。结果 CIMT增厚组血清Betatrophin高于CIMT正常组(P<0.01)。相关分析显示,血清Betatrophin与年龄、病程、收缩压(SBP)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、FINS、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、甘油三酯(TG)呈正相关(r分别为0.326、0.167、0.230、0.347、0.159、0.302、0.436、0.329、0.348,P<0.05或<0.01);CIMT与年龄、病程、体质量、腰围、腰臀比、BMI、SBP、HOMA-IR、HbA1c、TG、Betatrophin呈正相关(r分别为0.580、0.365、0.181、0.279、0.175、0.170、0.248、0.252、0.193、0.218、0.408,P<0.05或<0.01)。多元逐步回归分析结果显示:血清Betatrophin、年龄、体质量是T2DM患者CIMT增厚的影响因素。结论 T2DM患者血清Betatrophin水平升高可促进CIMT增厚,此作用可能是通过促进胰岛素抵抗及升高血脂而实现的。

Objective To investigate the effects of serum betatrophin levels on carotid intima-media thickness（CIMT） in patients with type 2 diabetes mellitus（T2DM）. Methods A total of 200 T2DM patients were enrolled in this study,including 100 patients with normal CIMT（CIMT 〈 1. 0 mm,normal CIMT group） and 100 patients with thickening CIMT（CIMT≥1. 0 mm,thickening CIMT group）. The serum betatrophin was analyzed by ELISA,and the other related biochemical indexes such as plasma glucose,plasma lipids,and fasting insulin（FINS） were measured. Results The serum betatrophin in the thickening CIMT group was higher than that of the normal CIMT group（P 〈 0. 01）. Correlation analysis showed that the serum betatrophin was positively correlated with age,disease duration,systolic blood pressure（SBP）,FPG,2 h PG,FINS,homeostasis model assessment of insulin resistance（HOMA-IR）,HbA1 cand triglyceride（TG）（r = 0. 326,0. 167,0. 230,0. 347,0. 159,0. 302,0. 436,0. 329,and 0. 348; P 〈 0. 05 or P 〈 0. 01）; CIMT was positively correlated with age,duration,body weight,waistline,waist-hip ratio,BMI,SBP,HOMA-IR,HbA1 c,and TG（r = 0. 580,0. 365,0. 181,0. 279,0. 175,0. 170,0. 248,0. 252,0. 193,and 0. 218; P 〈 0. 05 or P 〈 0. 01）.Multiple stepwise regression analysis showed that serum betatrophin,age,and body weight were the risk factors for CIMT in patients with T2DM. Conclusion The elevated serum level of betatrophin in patients with T2DM can promote the increase of CIMT,which may be achieved by promoting IR and increasing plasma lipids.