老年2型糖尿病患者外周血内皮祖细胞的功能及数量

摘要

目的：观察老年2型糖尿病（T2DM）患者体内内皮祖细胞（EPCs）的功能（以黏附细胞数表示为TNE－A）及其数量（以外周血计数表示为TNE），探讨其在老年T2DM发生发展中的作用。方法选择老年T2DM患者30例和老年正常对照10例，密度梯度离心法从外周血获取单个核细胞，接种在培养板内，培养7 d后对贴壁细胞进行测定；流式细胞仪鉴定FITC标记荆豆凝血素Ⅰ（ FITC－UEA－I）和 DiI标记的乙酰化低密度脂蛋白（ DiI－acLDL）双阳性细胞为正常分化的EPCs；胰蛋白酶消化后计数贴壁细胞观察TNE－A计数。同时采用流式细胞仪测定外周血 TNE计数。结果①老年T2DM患者EPCs的TNE－A较正常对照组显著减少，并且血管病变组间也有差异（t＝2．185、2．099；P＜0．05）。外周血TNE较正常对照组减低（t＝2．179； P＜0．05），但血管病变各组间无差异（t＝1．857； P＞0．05）。②随血糖及糖化血红蛋白（HbA1c）升高，T2DM老年患者 TNE－A以及 TNE计数逐渐降低（ t＝2．872、2．855、2．985、2．861；P＜0．01），组间有统计学差异（ t＝2．122、2．103、2．105、2．175；P＜0．05）。③Spearman 相关分析显示， TNE－A水平与低密度脂蛋白（ LDL）、舒张压（ SBP）、2 h 餐后血糖（2 h PBG）、HbA1c 呈负相关（ r分别为－0．40、－0．39、－0．21、－0．24，P＜0．01或＜0．05）。而外周血TNE与空腹血糖（FBG）、HbA1c呈负相关（r分别为－0．231、－0．267，P＜0．05）。④以T2DM 为整体，有血管病变为因变量（有＝1，无＝0），以年龄等危险因素为自变量，进行Logistic回归分析，SBP、TNE－A进入回归方程。结论 T2DM老年患者EPCs的黏附功能明显受损，与其血管病变关系较大；而外周血EPCs 数目与血管病变关系较小，EPCs生物学功能仍需进一步研究。%Objective To investigate the clinical significance of endothelial progenitor cells ( EPCs ) from the older type 2 diabetes mellium(T2DM)patients by the mumbles of EPCs in peripheral blood (TNE)and the adherent mumbles of EPCs cells (TNE-A).Methods EPCs isolated from human peripheral blood of the older T 2DM patient(n=30)and age matched control subjects (n=10).Cytochemical analy-sis was conducted after 7 days culture .EPCs were characterized as Dil-acLDL/FITC-UEA-1 double positive cell detected by FCM .EPCs ad-hesion assay was performed by replacing those on fibronectin-coated dishes .Then TNE-A was counted .TNE in peripheral blood wass detected by FCM.Results TNE-A was significantly impaired in older T2DM group compared with control group (t=2.185,2.099;P<0.05).TNE was deceased in older T2DM patient(t=2.179,P<0.05).TNE-A and TNE were decreased significantly (t=2.872,2.855,2.985,2.861;P<0.01)than those of control group and were also different with the increase of the glucose and HbAlc (P<0.05).There were negative corre-lation between TNE-A and LDL,SBP,2hPBG,HbAlc and too negative correlation between TNE and FBG ,HbAlc(P<0.05 )by Spearman rel-ative analysis.The SBP and TNE-A were valuable by Logistic regressive analysis .Conclusions These findings suggest adhesion function of EPCs may be play an important role in the development of DM .EPCs dysfunction need be further investigated .