抵抗素与2型糖尿病合并冠心病患者血管内皮功能和胰岛素抵抗的相关性研究

摘要

目的 探讨抵抗素(resistin)与2型糖尿病(DM)合并冠心病患者血清内皮素(ET-1)、一氧化氮(NO)、一氧化氮合酶(NOS)、胰岛素抵抗(IE)的相关性及其在糖尿病合并冠心病发生发展中的作用.方法 糖尿病患者组120例[其中单纯糖尿病60例(DM组),合并冠心病60例(DC组)]和正常组60例,采用酶联免疫吸附法(ELISA)、硝酸还原酶法、酶比色法测定3组血清空腹胰岛素、resistin、ET-1、NO、NOS水平.用空腹血糖(FBG)和空腹胰岛素的数值计算胰岛素抵抗指数(HOMA-IR).结果 DM血清resistin、ET-1、HOMA-IR显著高于正常组(P<0.05),而NO、NOS显著低于正常组(P<0.05),且并发冠心病患者血清resistin、ET-1、HOMA-IR显著高于DM组(P<0.05),NO、NOS显著低于DM组(P<0.05).相关性分析显示,升高的resistin与ET-1、HOMA-IR呈正相关(P<0.05),与NO、NOS呈负相关(P<0.05).结论 血清resistin、ET-1、NO、NOS水平与糖尿病病情发展存在相关性.对以上指标的测定有利于监测糖尿病病情发展,并对预防其并发症具有重要临床意义.%Objective To investigate the correlation between resistin and serum endothelin ( ET-1 ), nitric oxide ( NO ), nitric oxide synthase ( NOS ), insulin resistance ( IE ) in patients with type 2 diabtes mellitus ( DM ) complicated by coronary heart disease, and to explore the effect of resistin in the pathogenesis and development of type 2 DM complicated by coronary heart disease ( CHD ). Methods The study included three groups, the 120 patients with DM were divided into two group, simple DM group ( n = 60 ) and DM with CHD group ( n = 60 ), and 60 healthy subjects in control group. The levels of fasting insulin were detected by chemical luminescence method,ET-1 by enzyme linked immunosorbent assay ( ELISA ), NO by nitrate reductase method, NOS by enzymatic colorimetric method for the patients and controls. The insulin resistance index ( HOMA-IR ) was calculated according to the numerical value of fasting blood glucose ( FBG ) and fasting insulin. Results The serum levels of resistin,ET-1,HOMA-IR in simple DM group were significantly higher than those in control group ( P＜0. 05 ), however, the levels of NO, NOS were significantly lower than those in control group ( P＜0. 05 ), furthermore,the levels of resistin,ET-1,HOMA-IR in DM with CHD group were significantly higher than those in simple DM group ( P＜0. 05 ), but the levels of NO, NOS were significantly lower than those in simple group ( P ＜0. 05 ). The results of correlation analysis showed that the increase of resistin was positively related with the levels of ET-1,HOMA-IR( P＜0.05 ),however, which was negatively related with the levels of NO,NOS( P＜ 0.05 ). Conclusion The levels of serum resistin, ET-1, NO, NOS are correlated with the progression of disease ( DM ), so the detection for these parameters is helpful to monitoring the progression of disease ( DM ), which has important clinical significance in the prevention of complications of DM.