2型糖尿病患者血管并发症与血清von Willebrand因子的关系

Relationship between angiopathy in type 2 diabetics and serum von Willebrand Factor

为探讨糖尿病患者的血管内皮细胞功能损伤与微血管、大血管并发症之间的关系 ,将 334例 2型糖尿病患者根据是否合并有血管并发症分为无并发症组 (10 8例 )、大血管并发症组 (10 4例 )、大血管和微血管并发症组 (12 2例 )。观察不同组患者血清vonWillebrand因子 (vWF)水平 ,并与正常对照组 (10 5例 )比较。结果表明血清vWF水平在正常对照组为 0 82± 0 38U mL ;无并发症组 1 15± 0 39U mL ;大血管并发症组 1 30± 0 4 6U mL ;大血管和微血管并发症组 1 5 1± 0 5 0U mL ;血清vWF水平随血管并发症增多而上升 ,各组之间均有非常显著性差异 (P <0 0 1)。多因素Logistic回归分析表明vWF既与是否患有微血管病变显著相关 (P <0 0 5 ) ,也与是否患有大血管病变呈非常显著相关 (P <0 0 0 1)。多元逐步回归分析表明年龄、尿微量白蛋白、糖尿病视网膜病变、高血压分别与vWF呈显著正相关 (P <0 0 5 )。本研究提示在糖尿病患者中存在不同程度的微血管和大血管内皮细胞的损伤 。

To identify the relationship between serum von Willebrand Factor (vWF) and microangiopathy / macroangiopathy in diabetics. 334 cases of type 2 diabetes were divided into three groups: complication free group (n=108), macroangiopathy group (n=104), micro & macroangiopathy group (n=122). One hundred and five normal subjects served as normal control group. Serum von Willebrand Factor was measured by ELISA. The concentration of serum von Willebrand Factor was 0.82±0.38 U/mL in normal control group, 1.15±0.39 U/mL in complication free group, 1.30±0.46 U/mL in macroangiopathy group and 1.51±0.50 U/mL in micro & macroangiopathy group, there were significant differences among the groups( P <0.01). Logistic backward regression analysis showed that serum von Willebrand Factor significantly correlated not only with microangiopathy(R=0.1377, P=0.031),but also with macroangiopathy ( R=0.1662, P=0.0005).Multiple backward regression analysis showed that age, urinary microalbumin, diabetic retinopathy and hypertension were correlated with serum von Willebrand Factor(β= 0.29,0.22, 0.16, 0.14, P <0.05) respectively. Serum von Willebrand Factor gradually increased with the development of angiopathy in patients with type 2 diabetes. So there is a potential linkage between serum von Willebrand Factor and microangiopathy / macroangiopathy in type 2 diabetic patients.