T2DM合并微血管病变与凝血四项、C肽、胰岛素抵抗水平的关系

Correlation between T2DM combined with microangiopathy and coagulation parameters, C-peptide, insulin resistance

目的分析2型糖尿病(T2DM)合并微血管病变与凝血四项、C肽、胰岛素抵抗水平的关系。方法 T2DM患者根据是否合并微血管病变分为微血管病变组42例与非微血管病变组38例。患者均行糖化血红蛋白、空腹血糖、空腹胰岛素、空腹C肽、凝血四项等检测。分析T2DM合并微血管病变患者凝血四项与C肽、胰岛素抵抗水平的关系。结果 T2DM合并微血管病变患者凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)短于非微血管病变患者,纤维蛋白原含量高于非微血管病变组(P<0.05)。微血管病变组胰岛素抵抗较非微血管病变组明显。微血管病变组C肽含量显著高于非微血管病变组(P<0.05)。多因素Logistic回归分析结果显示(P<0.05),纤维蛋白原(FIB)、HOMA-IR与糖尿病微血管病变呈正相关(OR=1.34、1.56),C肽与糖尿病微血管病变呈负相关(OR=-1.47)。结论 T2DM合并微血管病变与凝血四项、胰岛素抵抗水平呈正相关,与C肽水平呈负相关,凝血四项、胰岛素抵抗水平可能是微血管病变发生的危险因素,C肽可能是微血管病变发生的保护因素。

Objective To analyze the relationship between type 2 diabetes mellitus(T2 DM) combined with microangiopathy and coagulation parameters, C-peptide, insulin resistance.Methods The patients with T2 DM were divided into microangiopathy group and nonmicroangiopathy group according to whether they were complicated by microangiopathy. All the patients were tested for glycosylated hemoglobin, fasting blood glucose, fasting insulin, fasting C-peptide and coagulation parameters. The relationship of coagulation parameters with C-peptide and insulin resistance of T2 DM patients with microangiopathy was analyzed.Results The prothrombin time(PT),activated partial thrombin time(APTT) and thrombin time(TT) in patients with T2 DM combined with microangiopathy were shorter than those in patients with nonmicroangiopathy(P<0.05). The fibrinogen content of the patients in microangiopathy group was higher than that in nonmicroangiopathy group(P<0.05). Moreover, the insulin resistance and the content of C-peptide in microangiopathy group were significantly higher than those in nonmicroangiopathy group(P<0.05). In addition, multivariate Logistic regression analysis showed that FIB and HOMA IR were positively correlated with diabetic microangiopathy(OR=1.34, 1.56), and C-peptide was negatively correlated with diabetic microangiopathy(OR=1.47).Conclusion T2 DM combined with microangiopathy is positively correlated with coagulation parameters and the level of insulin resistance, and negatively correlated with the level of C-peptide. Coagulation parameters and insulin resistance may be the risk factors for microangiopathy, and C-peptide may be the protective factor for microangiopathy.