2型糖尿病患者血清Vaspin水平与下肢血管病变严重程度的关系

摘要

Objective To explore the association between serum vaspin levels and the severity of the lower extremity vascular lesions in type 2 diabetes mellitus (T2DM) patients.Methods According to the lower extremity artery plaque,stenosis and intima-media membrane thickening severity score,92 cases of T2DM patients were divided into three groups:simple diabetes group (DM1 group) (32 cases),mild diabetic lower limb vascular lesion group (DM2 group) (33 cases),and moderately severe diabetic lower limb vascular lesion group (DM3 group) (27 cases).Twenty-six age-and gender-matched apparently healthy controls (control group) were recruited as well.Systolic blood pressure (SBP),ankle-brachial index (ABI),insulin resistance index (HOMA-IR),and other indicators were determined,serum vaspin was measured by enzyme-linked immunosorbent assay.Results After adjustment for age and gender,the DM1 group had a significantly higher serum vaspin level than control group (P ＜0.01),while for the DM2 and DM3 groups,serum vaspin levels were significantly lower than the DM1 group (P ＜ 0.01).Partial correlation analysis showed that serum vaspin was inversely associated with HOMA-IR (r =-0.461,P =0.001)and positively correlated with ABI (r =0.462,P =0.001).Logistic regression analysis demonstrated that SBP,ABI and fasting serum vaspin levels were significantly associated with the presence of the lower extremity vascular lesions in type 2 diabetes.Conclusions Serum vaspin levels were significantly elevated in simple type 2 diabetic patients while the reduction of its level might be associated with the formation of lower extremity vascular lesions in type 2 diabetic patients.%目的 探讨2型糖尿病(T2DM)患者血清腹腔脂肪型丝氨酸蛋白酶抑制剂(Vaspin)水平与下肢血管病变严重程度的关系.方法 选择T2DM患者92例,根据下肢血管内膜中层厚度、动脉斑块和狭窄程度评分,按照评分结果分为单纯糖尿病组(DM1组)(32例)、糖尿病合并轻度下肢血管病变组(DM2组)(33例)、糖尿病合并中重度下肢血管病变组(DM3组)(27例).另外选择健康查体者26例作对照组.测定收缩压(SBP)、血脂、踝肱指数(ABI)、胰岛素抵抗指数(HOMA-IR)及血清Vaspin水平.结果 校正年龄、性别后,DM1组的血清Vaspin水平显著高于对照组,而DM2组和DM3组血清Vaspin水平低于DM1组,差异有统计学意义(P均＜0.01).偏相关分析显示,血清Vaspin与HOMA-IR呈负相关(r=-0.461,P=0.001),与ABI正相关(r=0.462,P=0.001).Logistic回归分析显示,SBP、ABI和Vaspin水平是糖尿病发生下肢血管病变的独立危险因素.结论 血清Vaspin水平降低可能与T2DM患者下肢血管病变有关.