目的 探讨血清网膜素-1、游离脂肪酸(FFA)与2型糖尿病(T2DM)患者外周动脉疾病(PAD)的关系.方法 选取2013年9月至2014年12月于河南省人民医院内分泌科住院的T2DM患者92例,根据踝肱指数(ABI)将其分为T2DM无外周动脉疾病组(T2DM-NC组)43例和T2DM合并外周动脉疾病组(T2DM-PAD组)49例,另同期选择健康体检者40例为健康对照组(NC组),酶联免疫吸附测定(ELISA)法检测3组受试者血清网膜素-1水平,酶比色法测定3组受试者血清FFA水平,并对各变量行相关分析及logistic回归分析.结果 T2DM-PAD组、T2DM-NC组、NC组受试者血清网膜素-1水平分别为(25.45±4.03)、(33.28±6.50)、(43.08±5.94) μg·L-1,两两比较差异均有统计学意义(P＜0.05),血清FFA水平分别为(7.77±0.11)、(6.56±0.12)、(4.54±0.11)mmol·L-1,两两比较差异均有统计学意义(p＜0.05).相关分析结果表明,血清网膜素-1与空腹血糖(FPG)(r=-0.215,P＜0.05)、糖化血红蛋白(HbA1c)(r=-0.380,P＜0.05)、稳态模型评估胰岛素抵抗指数(HOMA-IR)(r=-0.366,p＜0.05)、胆固醇(TC)(r=-0.208,P＜0.05)呈负相关,与高密度脂蛋白胆固醇(HDL-C)(r=0.225,P＜0.05)、ABI(r=0.566,P＜0.05)呈正相关;血清FFA与FPG(r =0.231,P＜0.05)、HbA1c(r=0.363,P＜0.05)、HOMA-IR(r=0.328,P＜0.05)、TC(r=0.345,P＜0.05)、三酰甘油(TG)(r=0.239,P＜0.05)呈正相关,与HDL-C(r=-0.221,P＜0.05)、ABI(r=-0.348,P＜0.05)呈负相关.Logistic回归分析结果显示,网膜素-1、FFA、HbA1c、病程为T2DM患者发生PAD的影响因素.结论 血清网膜素-1、FFA可能参与了T2DM患者PAD的发生、发展.%Objective To explore the relationship of serum omentin-1 and free fatty acid (FFA) with peripheral arterial disease (PAD) in type 2 diabetic mellitus (T2DM)patients.Methods Ninety-two T2DM patients were selected in the Department of Endocrinology of Henan Provincial People's Hospital from September 2013 to December 2014.The patients were divided into T2DM without PAD group (T2DM-NC group,n =43) and T2DM with PAD group (T2DM-PAD group,n =49)according to the ankle brachial index (ABI).In addition,40 healthy volunteers were chosen as normal control group (NC group).The omentin-1 levels of patients in the three groups were measured by enzyme-linked immunosorbent assay (ELISA),and the serum FFA levels of patients in the three groups were measured by enzymatic colorimetry.All the variables were analysed by correlation analysis and logistic regression analysis.Results The serum level of omentin-1 in T2DM-PAD group,T2DM-NC group and NC group was (25.45 ±4.03),(33.28 ± 6.50),(43.08 ±5.94) μg · L-1 respectively;there was statistic difference in the omentin-1 level among the three groups (P ＜ 0.05).The serum level of FFA in T2DM-PAD group,T2DM-NC group and NC group was (7.77 ±0.11),(6.56 ±0.12),(4.54 ±0.11)mmol · L-1 respectively;there was statistic difference in the FFA level among the three groups(P ＜ 0.05).Correlation analysis showed that serum omentin-1 was negatively correlated with fasting plasma glucose (FPG) (r =-0.215,P ＜ 0.05),glycosylated hemoglobin (HbA1c) (r =-0.380,P ＜ 0.05),homeostasis model assessment of insulin resistance(HOMA-IR) (r =-0.366,P ＜ 0.05) and total cholesterol(TC) (r =-0.208,P ＜ 0.05),and was positively correlated with high density lipoprotein cholesterol (HDL-C) (r =0.225,P ＜ 0.05) and ABI (r =0.566,P ＜ 0.05);the serum FFA was positively correlated with FPG (r =0.231,P ＜ 0.05),HbA1 c (r =0.363,P ＜ 0.05),HOMA-IR (r =0.328,P ＜ 0.05),TC (r =0.345,P ＜ 0.05) and triglyceride (TG) (r =0.239,P ＜ 0.05),and was negatively correlated with HDL-C (r =-0.221,P ＜ 0.05) and ABI (r =-0.348,P ＜ 0.05).Logistic regression analysis showed that omentin-1,FFA,HbA1c and course of disease were the influencing factors of PAD in T2DM patients.Conclusion Serum omentin-1 and FFA may be involved in the occurrence and development of PAD in T2DM Patients.
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