目的 探讨血清脂肪因子Neuregulin 4 (Nrg4)水平与T2DM患者颈动脉内-中膜厚度(CIMT)的关系. 方法 选择T2DM患者85例,颈动脉彩色超声测定CIMT,CIMT＜0.9 rm为CIMT正常组(n=39),CIMT＞0.9 rm为CIMT增厚组(n=46),另选健康对照(NC)组(n=44).ELISA测定Nrg4浓度,同时测定其他代谢指标. 结果 NC组、CIMT正常组和CIMT增厚组血清Nrg4浓度依次下降(P＜0.05或P＜0.01).Spearman相关分析显示,CIMT与FPG、胰岛素抵抗指数(HOMA-IR)及糖尿病病程呈正相关(r=0.412、0.516、0.314,P＜0.01),与HDL-C及Nrg4呈负相关(r=-0.475、-0.373,P＜0.01).多元线性回归分析显示,FPG、Nrg4、HDL-C是CIMT的独立影响因素. 结论 脂肪因子Nrg4血清浓度在T2DM合并CIMT增厚患者中下降,可能在T2DM动脉粥样硬化形成中发挥作用.%Objective To investigate the relationship between serum neuregulin 4 (Nrg4) and carotid intima-media thickness (CIMT)in patients with type 2 diabetes (T2DM).Methods Total of 85 patients with T2DM were enrolled in this study and divided into two groups according to their CIMT:patients with normal CIMT(n=39,CIMT＜0.9 mm) and patients with increased CIMT (n=46,CIMT≥0.9 mm).And healthy subjects were also enrolled as NC group (n=44).Serum Nrg4 was measured by ELISA,and other metabolic parameters were also tested.Results Serum Nrg4 concentrations were gradually decreased in NC,CIMTnormal,and CIMT increased group (P＜0.05 or P＜0.01).Spearman correlation analysis showed that IMT was positively correlated with fasting plasma glucose (FPG) (r=0.412,P＜0.01),insulin resistance index HOMA-IR (r =0.516,P＜ 0.01) and durationof diabetes (r =0.314,P＜0.01),and negatively correlated with high density lipoprotein cholesterol (HDL-C) (r=-0.475,P＜0.01)and Nrg4 (r=-0.373,P＜0.01).Multiple linear regression analysis showed that FPG,Nrg4,HDL-C were independent factors for CIMT.Conclusion Serum Nrg4 concentrations significantly decreased in patients with T2DM and increased CIMT,and may play an important role in the formation of atherosclerosis in T2DM.
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