血清可溶性CD40配体在2型糖尿病微血管并发症中的表达及意义

Expression and significance of serum soluble CD40 ligand in microvascular complications of type 2 diabetes mellitus

目的探讨T2DM患者微血管并发症(DMA)血清可溶性CD40配体(sCD40L)水平变化及其临床意义。方法选取2016年7月至2018年7月于我院内分泌科住院治疗的T2DM患者203例,分为单纯T2DM组(T2DM,n=78)及合并DMA组(DMA,n=125);另选取同期我院体检健康者为正常对照组(NC,n=52)。测定各组sCD40L、FPG、TG、TC、HDL-C、LDL-C、HbA1c、FIns、UACR水平,采用稳态模型评估胰岛素抵抗指数。结果 DMA、T2DM组血清s CD40L水平高于NC组(P<0.05),DMA组血清sCD40L水平高于T2DM组(P<0.05)。Pearson相关分析显示,血清SCD40L水平与HbA1c、FBG、TG呈正相关(r=0.431、0.320、0.793,P<0.05)。Logistic回归分析显示,sCD40L、HbA1c、DM病程是T2DM患者DMA的影响因素。结论 sCD40L水平升高可能参与DMA的发生发展。

Objective To investigate the changes of serum soluble CD40 ligand(s CD40 L)levels in T2 DM patients with diabetic microangiopathy(DMA)and its clinical significance.Methods A total of203 patients with T2 DM who were admitted into endocrinology department of our hospital were enrolled in this study from July 2016 to July 2018.All the patients were divided into DMA group(DMA,n=125)and T2 DM group(T2 DM,n=78).Healthy people were selected as control group during the same period(NC,n=52).The levels of s CD40 L,FPG,TG,TC,HDL-C,LDL-C,Hb Acl,FIns and UACR were measured,and the degree of IR was evaluated by homeostasis model HOMA-IR index.Results Serum SCD40 L level was higher in DMA and T2 DM group than in NC group(P<0.05).Serum SCD40 L level was higher in DMA group than in T2 DM group(P<0.05).Pearson correlation analysis showed that serum SCD40 L was positively correlated with Hb A1 c,FBG,TG(r=0.431,0.320,0.793,P<0.05).Logistic regression analysis showed that s CD40 L,Hb A1 c and duration of diabetes were the risk factors for DMA in T2 DM patients.Conclusion The elevated level of s CD40 L may be involved in the occurrence and development of DMA.