2型糖尿病患者血清vaspin、APN水平与下肢血管病变的相关性研究

Correlation between Serum Vaspin and APN in Patients with Type 2 Diabetes Mellitus and Low Limb Vascular Disease

目的探讨2型糖尿病(T2DM)患者血清腹腔脂肪型丝氨酸蛋白酶抑制剂(vaspin)、脂联素(APN)水平与下肢血管病变(LVD)的相关性。方法 120例2型糖尿病(T2DM)患者根据是否存在LVD分为NON-LVD组68例和LVD组52例,另选取同期健康体检者50例作为对照组,酶联免疫吸附(ELISA)法检测各组血清vaspin、APN水平,并测定各组体质指数(BMI)、腰臀比(WHR)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)等相关指标,分析血清vaspin、APN水平与各生化指标的相关性,并分析T2DM伴LVD的危险因素。结果对照组、NON-LVD组、LVD组患者WHR、FBG、HbA1c、TG、FINS、HOMA-IR、TC、hs-CRP、ABI等呈升高趋势,血清vaspin、APN呈降低趋势,差异均有统计学意义(P<0.05,P<0.01);相关性分析显示血清vaspin、APN与ABI呈正相关,而与FBG、HbA1c、TG、hs-CRP和HOMA-IR呈负相关,且血清APN与vaspin呈明显正相关(P<0.05);多因素回归分析显示:血清vaspin、APN、HbA1c、HOMA-IR是T2DM伴LVD的独立危险因素。结论血清vaspin、APN水平降低是T2DM患者LVD发生的独立危险因素,可作为监测T2DM伴LVD发生和发展的重要参考指标。

Objective To investigate the correlation between serum vaspin and APN in patients with type 2 diabetes mellitus（T2DM）and low limb vascular disease （LVD）. Methods 120 patients with T2DM were divided into non-LVD group（68 cases）and LVD group（52 cases）according to the existence of LVD,in addition,50 healthy people during the same period of physical examination were selected as the control group.The level of vaspin and APN in serum were detected by ELISA.Meanwhile,BMI,WHR,FBG,HbA1c,and HOMA-IR in each group were also detected.The correlation between serum vaspin,APN and other indicators,and risk factors of T2DM with LVD were analyzed. Results The above indictors（WHR,FBG,HbA1c,TG,FINS,HOMA-IR,TC,hs-CRP,and ABI）showed the trend of increasing,while vaspin and APN in serum showed the trend of decreasing among three groups,and there was significantly differences（ P 〈0.05, P 〈0.01）.The correlation analysis showed that vaspin and APN in serum had positive correlation with ABI and had negative correlation with FPG,HbA1c,TG,hs-CRP,and HOMA-IR,and APN in serum had positive correlation with vaspin in serum （P 〈0.05）.The multiple factor regression analysis showed that vaspin,APN,HbA1c and HOMA-IR were independent risk factors of T2DM with LVD. Conclusion The decreasing of vaspin and APN in serum were independent risk factors of T2DM with LVD,which were as the important monitoring indictors of the occurence and development of T2DM with LVD.