2型糖尿病血管病变患者TIPE2与TF的检测及临床意义

Expression and clinical significance of TIPE2 and TF in T2DM patients with vascular complications

目的观察2型糖尿病(T2DM)血管病变患者外周血单个核细胞(PBMCs)内肿瘤坏死因子α诱导蛋白8样分子2(TIPE2)、组织因子(TF)的表达与血浆肿瘤坏死因子(TNF)-α和TF水平的变化,并探讨其与T2DM血管病变的相关性。方法收集广州医科大学附属第二医院番禺院区2015年5月-2016年5月收治并确诊为T2DM患者78例,根据是否合并有血管病变分为血管病变(T2DM+V)组36例和非血管病变(T2DM)组42例,另择40例同期行健康体检者为对照(CON)组。收集患者年龄、性别等一般资料,采用高效液相色谱法测定糖化血红蛋白(HbA1c);全自动生化分析仪检测总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等生化指标;实时荧光定量PCR检测PBMCs中TIPE2、TF mRNA的表达水平;ELISA法测定血浆TF和TNF-α浓度。比较3组间各指标的差异并分析TIPE2 mRNA与TF mRNA、TF及TNF-α的相关性。结果 3组间性别、年龄、血脂方面差异无统计学意义(P>0.05);CON组、T2DM组和T2DM+V组HbA1c依次升高,PBMCs中TIPE2 mRNA表达依次下降,TF mRNA表达则依次升高(P<0.05);血浆TF、TNF-α水平依次增高(均P<0.05);T2DM+V组内TIPE2 mRNA与TF mRNA及TNF-α均呈负相关(r分别为-0.340和-0.342,P<0.05)。结论 T2DM血管病变的发生发展与TIPE2的下降及TF的升高有关。

Objective To investigate the expression levels of tumor necrosis factor-α induced protein 8 like-2 (TIPE2) and tissue factor (TF) mRNA in peripheral blood mononuclear cells (PBMCs) and changes of plasma levels of tumor necrosis factor-α(TNF-α) and TF in patients with type 2 diabetes mellitus (T2DM), and to explore the correlation between them and vascular complications. Methods A total of 78 patients diagnosed as T2DM and admitted to Panyu district, the 2nd Affiliated Hospital of Guangzhou Medical University from May 2015 to May 2016 were included in this study. Patients were divided into two groups according to whether they were combined with vascular complications: 42 cases in simple T2DM group and 36 cases in T2DM combined with vascular complication group (T2DM + V). Forty healthy people in healthy physical examination at the same period were enrolled in this study as the control group (CON). Data of age and gender were recorded in three groups. The glycosylated hemoglobin (HbA1c) was detected by high performance liquid chromatography. Fasting peripheral blood samples were collected in early morning, and serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected by automatic biochemical analyzer. The expression of TIPE2 and TF mRNA in PBMCs were detected by RT-PCR, and plasma levels of TF and TNF-α were tested by ELISA. All these indicators were compared, and the correlation of TIPE2 mRNA with TF mRNA, plasma TF and TNF-α were analyzed between the three groups. Results There were no significant differences in age, gender, TC, TG, HDL-C and LDL-C between three groups (P>0.05). Values of serum HbA1c increased in turn in CON group, T2DM group and T2DM+V group. PBMCs TIPE2 mRNA expressions decreased in turn, and the expressions of TF mRNA increased in turn in CON group, T2DM group and T2DM+V group (P<0.05). The plasma levels of TF and TNF-α were increased in turn in CON group, T2DM group and T2DM+V group (P<0.05). TIPE2 mRNA expression were negative correlated with TF mRNA and TNF-α in T2DM+V group (r=-0.340,-0.342, P<0.05). Conclusion The occurrence and development of T2DM vascular complications are correlated with increased TIPE2 and decreased TF.