脂蛋白相关磷脂酶A2与新诊断2型糖尿病患者大血管病变的相关性

摘要

目的:探讨新诊断2型糖尿病(T2DM)患者血浆脂蛋白相关磷脂酶A2(Lp-PLA2)水平与大血管并发症的关系.方法:选取103例新诊断T2DM患者,以颈动脉彩超结果分为糖尿病合并颈动脉粥样斑块组45例,颈动脉正常组58例,选择同期本院健康体检者58例为对照组.采用ELISA法检测3组受检者血浆Lp-PLA2水平,同时测定T2DM患者空腹及早餐后2h血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿酸、糖化血红蛋白(HbA1c)、空腹及餐后2hC肽、超敏C反应蛋白(hs-CRP)等指标,超声检查所有T2DM患者双侧颈动脉.结果:新诊断T2DM患者血浆Lp-PLA2水平显著高于健康对照组(P＜0.01),T2DM合并颈动脉粥样斑块组血浆Lp-PLA2水平显著高于颈动脉正常组(P＜0.01).相关分析显示,新诊断T2DM患者血浆Lp-PLA2水平与双侧颈内、总、外动脉中内膜厚度(IMT)均呈正相关(P＜0.01).Logistic回归分析显示,Lp-PLA2水平与T2DM大血管病变直接相关(P＜0.01).结论:Lp-PLA2是T2DM的独立危险因素之一,对预测T2DM大血管病变有一定意义.%Objective:To explore the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) and major vascular complications in type 2 diabetes mellitus(T2DM) patients.Methods:A total of 103 cases of newly diagnosed T2DM patients were selected,carotid color ultrasonography were used to divide those patients into the plaque of carotid arteries group (45 cases) and the non-plaque ofcarotid arteries group(58 cases).Fifty-eight healthy people during the same period in the hospital were chosen as a control.Lp-PLA2 level of three groups were measured by the ELISA test,meanwhile,fasting plasma glucose,2-hour plasma glucose after breakfast,total cholesterol (TC),triacyl glycerin (TG),high-density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),uric acid,glycosylated hemoglobin (HbA1 c),fasting and postprandial 2-hour C-peptide,hypersensitive C-reactive protein(hs-CRP) were measured,respectively.All the patients were examined with the carotid color ultrasonography.Results:Compared with the healthy people,Lp-PLA2 levels were sign.ificantly increased in the newly diagnosed T2DM patients (P ＜ 0.01).Moreover,the plaque of carotid arteries group had significantly higher Lp-PLA2 levels than non-plaque of carotid arteries group(P ＜ 0.01).Correlation analysis indicated strongly positive correlation between intima-media thickness(IMT) and the Lp-PLA2 levels in newly diagnosed T2DM patients(P ＜ 0.01).Logistic regression analysis revealed that Lp-PLA2 was directly related to macroangiopathy (P ＜ 0.01).Conclusion:Lp-PLA2 is one of the independent risk factors for the development of T2DM,and may be used to predict T2DM macroangiopathy.