2型糖尿病患者血清对氧磷酶1、CD147水平及其对颈动脉粥样硬化形成的影响

Serum levels of paraoxonase 1 and CD147 and their effects on development of carotid atherosclerosis in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者血清对氧磷酶1(PON1)、CD147水平及其对颈动脉粥样硬化(CAS)形成的影响。方法选取203例T2DM患者(T2DM组),根据颈动脉内中膜厚度(cIMT)分为CAS组(cIMT≥0.9 mm,n=57)和非CAS组(cIMT<0.9 mm,n=146)。另选取同时期体检的48例健康者作为对照组。比较T2DM组和对照组血清PON1、CD147水平;比较CAS组和非CAS组血清PON1和CD147水平、一般资料、常规生化指标。采用多因素Logistic回归模型分析T2DM患者发生CAS的影响因素。结果T2DM组血清PON1水平低于对照组,CD147水平高于对照组(均P<0.05)。与非CAS组相比,CAS组血清PON1水平降低,血清CD147、空腹血糖和糖化血红蛋白(HbA1c)水平升高,患者的年龄更大、病程更长(均P<0.05)。多因素Logistic回归分析结果显示,病程≥10年、血清HbA1c和CD147水平升高为T2DM患者发生CAS的危险因素,血清PON1水平升高为独立保护因素(均P<0.05)。结论T2DM患者血清PON1水平降低,CD147水平升高。PON1表达下调或CD147表达上调的T2DM患者发生CAS风险增加。

Objective To investigate serum levels of paraoxonase 1(PON1)and CD147 as well as their effects on the development of carotid atherosclerosis(CAS)in patients with type 2 diabetes mellitus(T2 DM).Methods A total of 203 patients with T2 DM(T2 DM group)were enrolled and were divided into CAS group(carotid intima-media thickness[cIMT]≥0.9 mm,n=57)and non-CAS group(cIMT<0.9 mm,n=146)according to their cIMT.Concurrently,another 48 healthy individuals who underwent physical examination served as control group.Serum PON1 and CD147 levels were compared between the T2 DM group and the control group,and serum PON1 and CD147 levels,general data,and routine biochemical indicators were compared between the CAS group and the non-CAS group.The multivariate Logistic regression model was employed to analyze the factors influencing the occurrence of CAS in T2 DM patients.Results The T2 DM group yielded a lower serum PON1 level and a higher CD147 level than the control group(all P<0.05).Compared with the non-CAS group,the CAS group had a decreased serum PON1 level,elevated serum levels of CD147,FBG,and hemoglobin A1 c(HbA1 c),older cases,and a longer course of disease(all P<0.05).The results of multivariate Logistic regression analysis showed that the course of disease≥10 years and elevated serum HbA1 c and CD147 levels were the risk factors for developing CAS in T2 DM patients,and an increased serum PON1 level was an independent protective factor(all P<0.05).Conclusion Patients with T2 DM experience a decreased serum PON1 level and an elevated CD147 level.T2 DM patients with down-regulated PON1 expression or up-regulated CD147 expression are at increased risks for developing CAS.