血清CYS-C、Hcy、MMP-9水平与中老年人2型糖尿病合并脑梗死的相关性研究

Association between serum levels of cystatin-C,homocysteine and MMP-9 in elderly type 2 diabetes patients with cerebral infaration

目的:探讨2型糖尿病合并脑梗死的中老年患者血清胱抑素-C(cystatin C,Cys-C)、同型半胱氨酸(Hcy)、基质金属蛋白酶-9(MMP-9)的变化及临床意义。方法:选取来我院就诊的中老年2型糖尿病(DM)患者126例,其中合并脑梗死的患者30例,单纯糖尿病患者96例,选择同期来我院行健康体检的健康对照者36例。测定所有受试者的空腹血糖(FBG)、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、糖化血红蛋白(Hb A1C)、血清Cys-C、Hcy、MMP-9的水平及颈动脉内膜中层厚度(CIMT)。结果:2型糖尿病合并脑梗死、单纯2型糖尿病的受试者的FBG、TG、TC、LDL、HDL、Hb A1C、血清Cys-C、Hcy、MMP-9及CIMT与健康对照组差异有显著差异,且2型糖尿病合并脑梗死的各指标与单纯2型糖尿病差异亦有显著差异。血清Cys-C水平与CIMT呈正相关。血清Cys-C可能是2型糖尿病合并脑梗死发病的独立预测因子。结论:联合血清CYS-C、Hcy、MMP-9水平的测定对预测中老年人2型糖尿病合并脑梗死可能更优。

Objective To analyze serum levels of cystatin C,homocysteine and MMP-9 in elderly type 2 diabetes patients with cerebral infaration and their clinical significances. Methods One hundred and twenty-six elderly diabetes patients were divided into DM group(n=96)and diabetes combined cerebral infaration group(DCI,n=30).30 healthy persons during the same period were selected as healthy control group. Their general clinical data were collected,meanwhile their serum cystatin C,homocysteine and MMP-9 levels and their bilateral carotid intima media thickness(CIMT)were measured. Results The concentrations of fasting blood sugar,Hb A1 C,total cholesterol,triaoylglycerol,low density lipoprotein cholesterol and the serum levels of cystatin C,homocysteine and MMP-9 and CIMT in DCI group and DM group were significantly higher than those in control group,which were obviously higher in DCI group than those in DM group,the concentrations of high density lipoprotein cholesterol were markedly lower than those in control group,which were obviously lower in DCI group than those in DM group. The cartid intima-media thickness(CIMT)was positively correlated with serum levels of cystatin-C. The serum cystatin C level may be an independent risk factor for elderly type 2 diabetes patients with cerebral infaration. Conclusion Combined determination of serum levels of cystatin-C,homocysteine and MMP-9 in elderly type 2 diabetes patients with might be better factors for predicting.