2型糖尿病合并冠心病患者心外膜脂肪脂联素mRNA表达及意义

摘要

Objective To investigate the adiponectin mRNA expression in the surface of the heart adipose tissues of type 2 diabetes with coronary heart diesease and to explore their relationship with serum adiponectin,TC,TG,HDL,HbA1C,FINS,FPG,BMI.Methods The adiponectin mRNA expression level in the surface of the heart adipose tissue of 30 cases of type 2 diabetes with CHD(Group A,30 cases) and 30 cases of non-diabetes with CHD (Group B,30 cases)and 30 cases with congenital heart disease (Group C,30 cases)controls was assayed by real time fluorescence quantitative RT-PCR.The level of serum adiponectin was measured with ELISA kit.Results ①)TC,TG,BMI,FPG,FINS,HbAlc,HOMA—IR decreased significantly in order among group A,group B and group C while the aboce indices showed the highest in Group A and the lowest in Group C (P＜0.05).HDL,APN,the APN mRNA expression in the surface of the heart adipose tissues showed the highest in group C,middle in group B and the lowest in group C (P＜0.01).②There was no significant difference in TC,TG,HDL,BMI between group A and group B (P＞0.05).FPG,FINS,HbA1c,HOMA—IR of group A were higher significantly than those of group B(P＜0.05).APN,the APN mRNA expression in the surface of the heart adipose tissues of group A was significantly lower than those of group B (P＜0.01).Conclusion CHD patients with Type 2 diabetes show lower transcription of APN and the APN mRNA in the surface of the heart adipose tissue than that of non-diabetic CHD patients.HbA1 c,B MI,HOMA—IR,HDL are correlated with the APN mRNA expression in the surface of the heart adipose tissues.%目的 探讨2型糖尿病合并冠心病患者心外膜脂肪脂联素mRNA(APN mRNA)表达水平及其与血清脂联素(APN)、血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、空腹血糖(FPG)、体重指数(BMI)等相关指标的关系.方法 采用ELISA方法测定2型糖尿病合并冠心病组(A组,30例)、单纯冠心病组(B组,30例)和先心病组(C组,30例)血清APN水平,同时检测血清TC、TG、HDL、HbA1c、FINS和FPG,并计算BMI和胰岛素抵抗指数(HOMA-IR).收集A、B、C三组患者心外膜脂肪,分离、提取细胞RNA,用实时荧光定量RT-PCR技术检测心外膜脂肪APN mRNA的表达水平.结果 ①A组、B组、C组三组比较,TC、TG、BMI依次降低(P＜0.01),FPG、FINS、HbA1c、HOMA-IR依次降低(P＜0.05),HDL、APN、心外膜脂肪组织APN mRNA依次升高(P＜0.01).②A组与B组比较,TC、TG、HDL、BMI差异无统计学意义(P＞0.05),A组FPG、FINS、HbA1c、HOMA-IR均高于B组(P＜0.05),A组APN、心外膜脂肪APN mRNA低于B组(P＜0.01).结论 2型糖尿病合并冠心病患者心外膜脂肪APN mRNA及血清APN表达较单纯冠心病患者显著降低,HbA1c、BMI、HOMA-IR、HDL等临床指标可间接反映心外膜脂肪APN mRNA 水平.