血清补体C1q肿瘤坏死因子相关蛋白-3在阻塞性睡眠呼吸暂停低通气综合征加重2型糖尿病患者下肢血管病变中的作用

Role of serum CTRP3 in lower extremity vascular lesion in patients with type 2 diabetes mellitus aggravated by OSAHS

目的探讨血清补体C1q肿瘤坏死因子相关蛋白(CTRP)3在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)加重2型糖尿病(T2DM)患者下肢血管病变中的作用。方法选取T2DM合并OSAHS患者171例为病例组,单纯T2DM患者231例为对照组,将病例组分为合并轻度OSAHS组(A亚组)和合并中重度OSAHS组(B亚组)。采用彩色多普勒超声检查下肢血管病变,酶联免疫吸附实验检测血清CTRP3水平,同时监测睡眠呼吸紊乱指数(AHI)、夜间最低血氧饱和度(LSaO_2)。结果病例组下肢血管病变检出率显著高于对照组(P<0.05),血清CTRP3水平显著低于对照组(P<0.05);A亚组下肢血管检出率显著低于B亚组(P<0.05),血清CTRP3水平显著高于B亚组(P<0.05);Pearson相关分析显示,病例组内下肢血管病变评分与AHI呈正相关(r=0.714,P<0.05),与LSaO_2呈负相关(r=-0.598,P<0.05),血清CTRP3与AHI呈负相关(r=-0.777,P<0.05),与LSaO_2呈正相关(r=0.653,P<0.05);与CTRP3正常患者相比,CTRP3异常患者下肢血管病变检出率更高(P<0.05)。结论 OSAHS可加重T2DM患者下肢血管病变,其机制与血清CTRP3水平降低有关。

Objective To investigate the role of serum C1 q/TNF-related protein(CTRP) 3 in lower extremity vascular lesion in patients with type 2 diabetes mellitus(T2 DM) aggravated by obstructive sleep apnea hypopnea syndrome(OSAHS).Methods 171 patients of T2 DM combined with OSAHS were selected as case group,231 patients with T2 DM were selected as control group.Case group was divided into moderate or severe OSAHS complicated with T2 DM(A subgroup) and mild ones(B subgroup).Lower extremity vascular lesion was detected by color Doppler ultrasound.Serum CTRP3 level was determined by enzyme-linked immunosorbent assay,monitoring apnea-hypopnea index(AHI) and lowest oxygen saturation(LSaO2) at the same time.Results The detection rate of lower extremity vascular lesions in the case group was higher than that of control group(P<0.05),and serum CTRP3 level was lower than that of control group(P<0.05).In subgroup analysis, the detection rate of lower extremity vascular lesions in A subgroup was higher than that of B subgroup(P<0.05),and serum CTRP3 level was lower than that of B subgroup(P<0.05). The score of lower extremity vascular lesions was positively correlated with AHI(r=0.714,P<0.05),while negatively correlated with LSaO2(r=-0.598,P<0.05).Serum CTRP3 level was negatively correlated with AHI(r=-0.777,P<0.05),while positively correlated with LSaO2(r=0.653,P<0.05).The detection rate of lower extremity vascular lesions in patients with abnormal CTRP3 was higher than that of normal CTRP3 patients(P<0.05).Conclusions OSAHS could aggravate the lower extremity vascular lesions in T2 DM patients,which is related to serum CTRP3 level depression.