2型糖尿病合并颈动脉粥样硬化患者血清丝氨酸蛋白酶抑制剂B1水平变化的研究

Changes of serum level of serine protease inhibitor B1 in patients with type 2 diabetes mellitus complicated with carotid atherosclerosis

目的探讨T2DM合并颈动脉粥样硬化(CAS)患者血清丝氨酸蛋白酶抑制剂B1(SerpinB1)水平变化。方法选取2018年2月至2019年3月于苏州大学附属第一医院内分泌科住院的T2DM患者119例,血压、血脂均正常。根据颈动脉超声结果分为T2DM合并CAS组(T2DM+CAS)62例,单纯T2DM组(T2DM)57例。另选取同期我院健康体检人群56名为正常对照(NC)组。收集各组一般资料及生化指标,ELISA法测定血清SerpinB1浓度。结果 NC、T2DM组SerpinB1水平差异无统计学意义(P>0.05),但低于T2DM+CAS组(P<0.01)。Pearson相关分析显示,血清SerpinB1水平与糖尿病病程、FPG、HbA1c、胰岛素抵抗指数呈正相关(r=0.215、0.240、0.244、0.203,P<0.05或P<0.01)。Logistic回归分析显示,SerpinB1、年龄、LDL-C是T2DM合并CAS患者的独立危险因素(P<0.05或P<0.01)。结论 T2DM合并CAS患者血清SerpinB1水平升高,可能在CAS的发生发展中发挥作用。

Objective To investigate the changes of serum level of serine protease inhibitor B1(SerpinB1)in patients with type 2 diabetes mellitus(T2DM)complicated with carotid atherosclerosis(CAS).Methods A total of 119 patients with T2DM were selected in this study from the Endocrinology Department of the First Affiliated Hospital of Soochow University.All the patients were with normal blood pressure and serum lipid levels.They were divided into two groups according to the results of carotid ultrasound:T2DM patients with CAS(T2DM+CAS group,n=62),T2DM patients without CAS(T2DM group,n=57).Meanwhile,healthy subjects were selected as the normal control group(NC,n=56).Clinical characteristics and biochemical indexes were collected in all the subjects.Serum SerpinB1 concentration was determined by enzyme linked immunosorbent assay(ELISA).Results There was no significant difference of SerpinB1 levels between NC group and T2DM group(P>0.05),but significantly lower than in T2DM + CAS group(P<0.01).Pearson correlation analysis showed that SerpinB1 was positively correlated with duration of diabetes,fasting plasma glucose(FPG),hemoglobin A1c(HbA1c)and HOMA-IR(r=0.215,0.240,0.244,0.203,P<0.05 or P<0.01).Logistic regression analysis showed that SerpinB1,age and low density lipoprotein cholestero(lLDL-C)were independent risk factors for CAS in patients with T2DM(P<0.05 or P<0.01).Conclusion Serum SerpinB1 was elevated in patients with T2DM complicated with CAS,and may play a role in the pathogenesis of CAS in patients with T2DM.