血管生成素样蛋白2、抵抗素及脂联素与2型糖尿病患者颈动脉斑块形成的关系研究

The relationship between Angptl2,resistin,adiponectin and carotid plaque formation in patients with T2DM

目的探讨血清血管生成素样蛋白2(Angptl2)、抵抗素及脂联素变化与2型糖尿病(T2DM)患者颈动脉斑块形成的关系。方法选择2015年12月至2018年9月在杭州市第一人民医院确诊的T2DM患者191例,分为伴颈动脉斑块的观察组(91例)和不伴颈动脉斑块的对照组(100例)。测定和比较两组患者的一般资料[体重指数(BMI)、收缩压、腰臀比]和生化指标[空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、Angptl2、抵抗素及脂联素水平。采用多因素logistic回归分析形成颈动脉斑块的影响因素。结果观察组血清TC、TG、Angptl2和抵抗素水平高于对照组,HDL-C和脂联素低于对照组,差异均有统计学意义(均P<0.05)。TC、TG、Angptl2、抵抗素水平增高,HDL-C及脂联素降低是T2DM患者发生颈动脉斑块形成的独立危险因素(均P<0.05)。结论Angptl2和抵抗素水平增高及脂联素降低与T2DM患者颈动脉斑块形成相关。

Objective To investigate the relationship between angiopoietin-like protein 2(Angptl2),resistin and adiponectin and carotid plaque formation in patients with type 2 diabetes mellitus(T2DM).Methods A total of 191patients with T2DM were enrolled in Hangzhou First People’s Hospital from December 2015 to September 2018 and divided into observation group with carotid plaques(n=91)and control group without carotid plaques(n=100).Body mass index(BMI),systolic blood pressure(SBP),waist-to-hip ratio(WHR),fasting blood glucose(FPG),glycosylated hemoglobin(Hb A1c),fasting insulin(FINS),insulin resistance index(HOMA-IR),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),Angptl2,resistin and adiponectin were measured and compared between the two groups.Multivariate logistic regression analysis was used to evaluate the risk factors of carotid atherosclerotic plaque formation.Results The levels of TG,Angptl2 and resistin were significantly higher in observation group than in the control group(all P<0.05).HDL-C and adiponectin were significantly lower in observation group than in the control group(all P<0.05).The increase of TC,TG,Angptl2 and resistin and the decrease of HDL-C and adiponectin were independent risk factors for carotid plaque formation(all P<0.05).Conclusion Increased Angptl2 and resistin and decreased adiponectin are related to carotid plaque formation in T2DM patients.