2型糖尿病患者血清脂联素、25羟维生素D、血脂与下肢血管病变关系的研究

Correlation analysis between serum level of APN,25(OH)D and lipid with lower limb peripheral arterial disease in patients with type 2 diabetes mellitus

目的探讨T2DM患者血清脂联素(APN)、25羟维生素D[25(OH)D]、血脂与下肢血管病变的关系。方法选取2017年8月至2018年1月于我院内分泌科住院的100例T2DM患者,按照踝肱指数(ABI)分为T2DM合并下肢血管病变组(PAD,n=50)和T2DM组(n=50);另选同期我院健康体检者50名为正常对照组(NC)。ELISA检测血清APN水平,化学发光法检测25(OH)D水平,采用日立全自动生化分析仪检测血脂,分析其与下肢血管病变的关系。结果 T2DM组及PAD组APN水平低于NC组[(6.76±0.42)vs(4.54±0.63)vs(10.12±2.43)nmol/L,P<0.05];PAD组血清APN水平低于T2DM组(P<0.05)。Pearson相关分析显示,PAD组血清APN水平与ABI、25(OH)D呈正相关(P<0.05),与BMI、FPG、2hPG、HbA_1c、TC、TG、LDL-C呈负相关(P<0.05或P<0.01)。Logistic回归分析结果显示,HbA_1c、LDL-C、APN、25(OH)D是T2DM合并下肢血管病变的影响因素。结论 T2DM合并下肢血管病变的发生发展与血清APN、25(OH)D水平的降低及血脂异常密切相关;高水平HbA1c、LDL-C及低水平APN、25(OH)D是T2DM合并下肢血管病变的影响因素。

Objective To investigate the correlation between serum level of APN,25（OH）D and lipid with lower limb peripheral arterial disease in patients with type 2 diabetes mellitus（T2 DM）.Methods A total of 100 patients with T2DM were enrolled in this study and divided into two groups according to the ankle brachial index（ABI）：PAD group（n=50）and T2DM group（n=50）.Healthy subjects were enrolled as healthy controls（NC group,n=50）.Serum APN level was measured by Enzyme linked immunosorbent assay（ELISA）.Serum 25（OH）D was detected by chemi-luminescence method,and serum lipid was measured by Hitachi automatic biochemical analyzer.The relationships between APN,25（OH）D and lipid with vascular lesions of lower extremities were analyzed. ResultsSerum APN level was significantly lower in T2DM and PAD group than in NC group[（6.76±0.42）vs（4.54±0.63）vs（10.12±2.43）nmol/L,P0.05].Serum APN level was significantly lower in PAD group than in T2DM group（P0.05）.Pearson correlation analysis showed that serum APN level was negatively correlated with BMI,FPG,2 hPG,HbA_1c,TC,TG,and LDL-C（P0.05 or P0.01）,and positively correlated with ABI and 25（OH）D（P0.05 in PAD group.Logistic regression analysis showed that HbA_1c,LDL-C,APN and 25（OH）D were independent influencing factors for T2DM patients accompanied with lower extremity vascular disease. Conclusion The occurrence and development of lower extremity vascular lesions in T2DM are closely related to the decrease of serum APN,25（OH）D level and dyslipidemia.The increase of HbA_1c,LDL-C and the decrease of APN and 25（OH）D level were independent risk factors for T2DM with lower extremity vascular disease.