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目的探讨血清脂联素水平与2型糖尿病(T2DM)患者颈动脉内中膜厚度(IMT)变化之间的关系。方法应用酶联免疫法测定140例IMT≤1mm的T2DM患者及80例正常对照者的血清脂联素水平,糖尿病组在生活方式干预的基础上,给予抗血小板聚集、强化血糖、血压、血脂治疗,随访12个月后重新测定IMT,按IMT分为两组(DM1组:IMT≤1mm,DM2组:IMT>1mm),分析血清脂联素水平与IMT变化之间的关系。结果(1)T2DM组血清脂联素水平低于对照组(6±3vs13±7mg/L,P<0.01)。(2)DM1组与DM2组相比较,腰臀比(0.90±0.07vs0.93±0.05,P=0.024)、HDL-C(1.28±0.36vs1.11±0.22mmol/L,P=0.013)、血清脂联素水平(6.07±3.31vs4.06±2.71mg/L,P=0.003),差异均有统计学意义。(3)Logistic回归分析显示,血清脂联素含量降低、年龄增长、HDL-C降低是T2DM患者IMT增厚的危险因素。结论低血清脂联素水平是T2DM患者动脉粥样硬化的独立危险因素。
Objective To investigate the relationship between serum adiponectin level and carotid artery intima-media thickness (IMT) in type 2 diabetes mellitus (T2DM). Methods Serum levels of adiponectin in 140 T2DM patients with IMT ≤1mm and 80 normal controls were measured by enzyme-linked immunosorbent assay (ELISA). On the basis of lifestyle intervention, diabetic patients were given anti-platelet aggregation, intensive blood glucose, blood pressure, After 12 months of follow-up, IMT was measured again and divided into two groups according to IMT (DM1 group: IMT≤1mm, DM2 group: IMT> 1mm). The relationship between serum adiponectin level and IMT change was analyzed. Results (1) The level of serum adiponectin in T2DM group was lower than that in control group (6 ± 3 vs13 ± 7 mg / L, P <0.01). (2) The HDL-C (1.28 ± 0.36vs1.11 ± 0.22mmol / L, P = 0.013) in the DM1 group was significantly lower than that in the DM2 group (0.90 ± 0.07vs0.93 ± 0.05, P = 0.024) Serum adiponectin levels (6.07 ± 3.31 vs 4.06 ± 2.71 mg / L, P = 0.003), the differences were statistically significant. (3) Logistic regression analysis showed that the decrease of serum adiponectin level, the increase of age and the decrease of HDL-C were the risk factors of IMT thickening in T2DM patients. Conclusion Low serum adiponectin level is an independent risk factor for atherosclerosis in T2DM patients.