血清非磷酸化-未羧化的基质gla蛋白水平与2型糖尿病患者膝下动脉钙化的相关性研究

摘要

Objective To investigate the relationship between serum dp-ucMGP levels and belowknee arterial calcification in patients with type 2 diabetes mellitus(T2DM).Methods 146 inpatients with T2DM were selected from May 2014 to May 2015 in department of endocrinology and vascular surgery in the first affiliated hospital of Gannan medical university.Serum dp-ucMGP levels were measured by ELISA method.All patients underwent lower extremity arteries CTA to score below-knee arterial calcification.The indicators of HbA1 c,serum calcium,phosphorus,serum PTH and 25(OH)D were also determined.Results According to the below-knee arterial calcification score,the subjects were divided into three groups:normal group (NC,n =20),mild or moderate calcification group (n =70) and severe calcification group(n=56) with serum dp-ucMGP levels of 330 (265.5,394.5),480 (407,553) and 720 (640,800) pmol/L,respectively (P ＜ 0.01).There were statistic differences in age,male proportion,cardiovascular disease history,BMI,WHR and serum PTH levels among three groups(P＜0.05 or P＜ 0.01).Multivariate logistic regression analysis showed that serum dp-ucMGP levels were positively associated with the scores of below-knee arterial calcification.Conclusion High dp-ucMGP levels are independently associated with below-knee arterial calcification score in patients with T2DM.%目的 探讨T2DM患者血清非磷酸化-未羧化的基质gla蛋白(dp-ucMGP)水平与膝下动脉钙化的关系. 方法 收集2014年5月至2015年5月于我院内分泌科或血管外科住院的146例T2DM患者,ELISA检测血清dp-ucMGP水平.所有研究对象均行下肢动脉64排螺旋CT血管成像(CTA)并计算膝下动脉钙化积分,检测患者HbA1c、血钙、血磷、甲状旁腺激素(PTH),25羟维生素D[25(OH)D水平. 结果 根据膝下动脉钙化积分分为:正常组(NC,n=20)、轻中度钙化组(n=70)和重度钙化组(n=56),各组血清dp-ucMGP水平分别为330(265.5,394.5)、480(407,553)、720(640,800) pmol/L (P＜o.01);与NC组比较,轻中度钙化组和重度钙化组男性、年龄、心血管疾病病史、BMI、WHR、血清PTH水平差异均有统计学意义(P＜0.05或P＜0.01).多因素回归分析发现,血清dp-ucMGP水平是膝下动脉钙化的独立预测因素,独立于年龄、性别、心血管疾病病史. 结论 血清高水平dp-ucMGP与T2DM患者膝下动脉钙化积分独立相关.