2型糖尿病患者血清骨硬化蛋白、25羟维生素D水平与下肢血管病变的相关性研究

Correlation analysis between serum sclerostin and 25(OH)D with lower limb peripheral arterial disease in patients with type 2 diabetes mellitus

目的探讨T2DM患者血清骨硬化蛋白(SOST)、25羟维生素D[25(OH)D]水平与下肢血管病变(PAD)的关系。方法选取2016年6~12月于我院内分泌科住院的T2DM患者120例,按照踝肱指数(ABI)分为T2DM合并PAD组(PAD,n=62)和T2DM组(n=58)。另选同期我院健康体检者作为正常对照组(NC,n=58)。ELISA检测血清SOST水平,化学发光法检测25(OH)D水平,分析SOST及25(OH)D与PAD的关系。结果 T2DM组及PAD组血清SOST水平高于NC组[(228.58±74.29)vs(241.03±83.18)vs(182.33±54.12)ng/L,P<0.05]。Pearson相关分析显示,PAD组ABI与HDL-C、25(OH)D呈正相关(P<0.05),与BMI、HbA1c、LDL-C、HOMA-IR、血清SOST呈负相关(P<0.05);多元逐步回归分析结果显示,HbA1c、25(OH)D及血清SOST是ABI的影响因素。结论血清SOST水平的升高及25(OH)D水平的降低,可能共同参与了T2DM合并PAD的发生发展。

Objective To investigate the relationship between serum sclerostin（SOST）and 25（OH）D with lower extremity vascular disease in patients with type 2 diabetes mellitus（T2DM）.Methods A total of 120 patients with T2DM were enrolled in this study and divided into two groups according to the ankle brachial index（ABI）：T2DM patients accompanied with lower extremity vascular disease（PAD group,n=62）and T2DM patients without lower extremity vascular disease（T2DM group,n=58）.Healthy subjects were enrolled as healthy controls（NC group,n=58）.Serum SOST level was measured by Enzyme linked immunosorbent assay（ELISA）.Serum 25（OH）D was detected by chemiluminescence method.The relationship between SOST,25（OH）D and vascular lesions of lower extremities was analyzed. Results Serum SOST level was significantly higher in T2DM group and PAD group than in NC Group[（228.58±74.29）vs（241.03±83.18）vs（182.33±54.12）ng/L,P0.05].Pearson correlation analysis showed that ABI was positively correlated with HDL-C and 25（OH）D,negatively correlated with BMI,HbA_1c,LDL-C,HOMA-IR and SOST（P0.05）.Multiple stepwise regression analysis showed that the levels of serum SOST,25（OH）D and HbA_1c were independent influencing factors for ABI. Conclusion The increase of serum SOST and the decrease of serum 25（OH）D levels may be related to the development of T2DM with lower extremity vascular disease.