[1]刘彦君a,梁君蓉b,庞晓宁a.血清趋化素及hs-CRP水平对2型糖尿病患者无症状亚临床动脉粥样硬化诊断的临床意义[J].现代检验医学杂志,2017,32(02):36-40.[doi:10.3969/j.issn.1671-7414.2017.02.010]
　LIU Yan-juna,LIANG Jun-rongb,PANG Xiao-ninga.Clinical Significance of Serum Chemerin and hs-CRP in the Diagnosis of Subclinical Atherosclerosis in Patients with Type 2 Diabetes[J].Journal of Modern Laboratory Medicine,2017,32(02):36-40.[doi:10.3969/j.issn.1671-7414.2017.02.010]
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血清趋化素及hs-CRP水平对2型糖尿病患者无症状亚临床动脉粥样硬化诊断的临床意义()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年02期
页码:
36-40
栏目:
论著
出版日期:
2017-03-25

文章信息/Info

Title:
Clinical Significance of Serum Chemerin and hs-CRP in the Diagnosis of Subclinical Atherosclerosis in Patients with Type 2 Diabetes
文章编号:
1671-7414(2017)02-036-05
作者:
刘彦君a; 梁君蓉b; 庞晓宁a
解放军第三医院a.内分泌代谢科; b.消化科,陕西宝鸡 721008
Author(s):
LIU Yan-juna; LIANG Jun-rongb; PANG Xiao-ninga
a.Department of Endocrinology and Metabolism; b.Department of Digestive,the Third Hospital of PLA,Shaanxi Baoji 721008,China
关键词:
血清趋化素;  高敏C反应蛋白;  2型糖尿病;  亚临床动脉粥样硬化
分类号:
R587.2; R446.112
DOI:
10.3969/j.issn.1671-7414.2017.02.010
文献标志码:
A
摘要:
目的 探讨血清趋化素及hs-CRP水平对2型糖尿病患者无症状亚临床动脉粥样硬化诊断的临床意义。方法 选择2012年1月～2015年12月住院的2型糖尿病患者55例作为研究对象(试验组,n=55),同时期非2型糖尿病正常患者55例作为对照(对照组,n=55)。应用全自动生化分析仪测定FPG,HbA1c,HDL-C,血清趋化素,TC,TG,LDL-C,INS等指标,应用彩色多谱勒设备测量颈动脉内膜中层厚度(C-IMT)。相关性采用Pearson相关分析,危险因素分析采用多元线性逐步回归分析。结果 试验组与对照组比较,两组在体质指数(BMI),腰臀比值(WHR),收缩压,踝臂指数,FPG,HbA1c,HDL-C,hs-CRP,C-IMT,HOMA2-IR和血清趋化素方面差异有统计学意义(t=-6.31～5.79,P≤0.01～0.03)。试验组和对照组患者,血清趋化素水平与WHR,HOMA2-IR,C-IMT和hs-CRP呈正相关(r=0.24～0.29,P=0.01～0.04)。C-IMT与年龄、WHR、收缩压、舒张压、FPG,HbA1c,糖尿病病程、hs-CRP呈正相关(r=0.15～0.68,P≤0.01～0.04); 与踝臂指数(WHR)呈负相关(r=-0.32～0.29,P≤0.01)。hs-CRP与HbA1c,HOMA2-IR,血清趋化素和C-IMT呈正相关(r=0.25～0.32,P≤0.01～0.04); 与TC和HDL-C呈负相关(r=-0.27～-0.25,P均为0.02)。Cox比例风险回归模型进行多因素分析结果显示:患者血清趋化素、HbA1c和hs-CRP升高是影响C-IMT的危险性因素(β=0.026～0.658,SE=0.015～0.033,t=2.532～3.421,P≤0.01～0.0.04)。结论 血清趋化素水平和hs-CRP水平升高是影响C-IMT的危险性因素,对2型糖尿病患者无症状亚临床动脉粥样硬化诊断具有重要的临床意义。
Abstract:
Objective To investigate the clinical significance of serum chemokine and hs-CRP levels in patients with type 2 diabetes mellitus with asymptomatic subclinical atherosclerosis.Methods The clinicpathological and follow-up data of 55 patients with Type 2 diabeticfrom 2012.1 to 2015.12 were collected and reviewed.At the same time,55patients with non type 2 diabetes were taken as control.Determination of FPG,HbA1c,HDL-C,TC,TG,LDL-C,INS and other indicators by automatic biochemicalanalyzer,the application of color Doppler ultrasound equipment measurement C-IMT.Correlation using Pearson correlation analysis,risk factor analysis usingmultiple linear stepwise regression analysis.Results Compared with the control group,the two groups in BMI,WHR,systolic blood pressure,ankle brachial index,FPG,HbA1c,HDL-C,hs-CRP,C-IMT,HOMA2-IR and serum chemokines were significantly different,with statistical significance(t=-6.31～5.79,P≤0.01～0.03).In 110 cases of experimental group and control group,the levels of serum chemokines were positively correlated with WHR,HOMA2-IR,C-IMT and hs-CRP(r=0.24～0.29,P=0.01～0.04).C-IMT and age,WHR,systolic blood pressure,diastolic blood pressure,FPG,HbA1c,diabetes duration,hs-CRP was positively correlated(r=0.15～0.68,P≤0.01～0.0.04),and the ankle brachial index was negatively correlated(r=-0.32～0.29,P≤0.01).Hs-CRP was positively correlated with HbA1c,HOMA2-IR,serum chemokine,C-IMT(r=0.25～0.32,P≤0.01～0.04),and was negatively correlated with TC and HDL-C(r=-0.27～-0.25,P all 0.02).Cox proportional hazard regression model for multivariate analysis showed that high serum chemokines,hs-CRP and HbA1c were the risk factors of C-IMT(β=0.026～0.658,SE=0.015～0.033,t=2.532～3.421,P≤0.01～0.04).Conclusion High serum levels of chemokines and hs-CRP are the risk factors of C-IMT,and it hasimportant clinical significance for the diagnosis of asymptomatic subclinical atherosclerosis in patients with type 2 diabetes mellitus.

参考文献/References:

[1] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2007年版)[J].中华内分泌代谢杂志,2008,24(2):1227-1245. Chinese Diabetes Society.Guidelines for the prevention and treatment of type 2 diabetes in China in 2007[J].Chin J Endocrinol Metab,2008,24(2):1227-1245.
[2] 梁 峰,沈珠军,方 全,等.对2015年美国糖尿病协会关于糖尿病患者心血管疾病和风险因素治疗的解读[J].中国医院用药评价与分析,2015,15(11):1425-1430. Liang F,Shen ZJ,Fang Q,et al.The interpretation of cardiovascular disease and risk factors in the 2015 American Diabetes Association[J].Analysis Drug-Use in Hospital of China,2015,15(11):1425-1430.
[3] 吴 彧,孙 琳,黄彦生,等.氧化应激与炎症在动脉粥样硬化发生发展中的作用及相关治疗药物研究[J].中国实用神经疾病杂志,2014,17(21):127-129. Wu Y,Sun L,Huang YS,et al.The role of oxidative stress and inflammation in the development of atherosclerosis and related therapeutic drugs[J].Chinese Journal of Practical Nervous Diseases,2014,17(21):127-129.
[4] 王 慧,王 博,郭 瑄.Toll样受体4和单核细胞趋化蛋白1与急性冠脉综合征的关系研究[J].现代检验医学杂志,2016,31(5):84-87. Wang H,Wang B,Guo X.Relation of Toll like receptor 4 and monocytechemotactic protein 1 with acute coronary syndrome[J].Journal of Modern Laboratory Medical,2016,31(5):84-87.
[5] 刘 敏,解春霞,谢小超,等.高血压合并OSAHS患者血清超敏C反应蛋白、颈动脉粥样硬化的研究[J].中国实用医药,2016,11(20):16-17. Liu M,Xie CX,Xie XC,et al.Research of serum high-sensitive C reactive protein and carotid atherosclerosis in hypertension complicated with OSAHS patients[J].China Practical Medicine,2016,11(20):16-17.
[6] 杜亚强,雷立存,王伟秀,等.深部脑白质缺血患者MRI表现与颈动脉粥样硬化斑块和颈动脉内膜中层厚度关系的研究[J].中国全科医学,2010,13(6B):1874-1876. Du YQ,Lei LC,Wang WX,et al.Relationship of MRI manifestations with carotid atherosclerosis and intima-media thickness in patients with deep brain white matter ischemic[J].Chinese General Practice,2010,13(6B):1874-1876.
[7] 王 丹,王养维,李 辉,等.2型糖尿病患者动脉粥样硬化病变与血清CTRP3和CTRP9水平的相关性研究[J].现代检验医学杂志,2015,30(6):20-24. Wang D,Wang YW,Li H,et al.Correlation reseach on atheroscleroticlesions with serum CTRP3,CTRP9 level in patients with type 2 diabetic[J].JMod Lab Med,2015,30(6):20-24.
[8] Roh SG,Song SH,Choi KC,et al.Chemerin-a new adipokine that modulatesadipogenesis via its own receptor[J].Biochemical & Biophysical Research Communications,2007,362(4):1013-1018.
[9] Wang D,Yuan GY,Wang XZ,et al.Plasma chemerin level in metabolic syndrome[J].Genetics & Molecular Research Gmr,2013,12(4):5986-5991.
[10] Ali TM, Hadidi KA. Chemerin is associated with markers of inflammation and predictors of atherosclerosis in Saudi subjects with metabolic syndrome and type 2 diabetes mellitus[J].Beni-Suef University Journal of Basic and Applied Sciences,2013,2(2):86-95.
[11] El-Mesallamy HO,El-Derany MO,Hamdy NM.Se-rum omentin-1 and chemerin levels are interrelated in patients with type 2 diabetes mellitus with or without is chaemic heart disease[J].Diabetic Medicine,2011,28(10):1194-1200.
[12] Hu W,Feng P.Elevated serum chemerin concentrations are associated withrenal dysfunction in type 2 diabetic patients[J].Diabetes Res Clin Pract,2011,91(2):159-163.
[13] Fatima SS,Bozaoglu K,Rehman R,et al.Elevated chemerin levels in Pakistani men:an interrelation with metabolic syndrome phenotypes[J].PLoS One,2013,8(2):e57113.
[14] Yoo HJ,Choi HY,Yang SJ,et al.Circulating che-merin level is independently correlated with arterial stiffness[J].Journal of Atherosclerosis & Thrombosis,2012,19(1):59-78.
[15] Dong B,Ji W,Zhang Y.Elevated serum chemerin levels are associated with the presence of coronary artery disease in patients with metabolic syndrome[J].Internal Medicine,2011,50(10):1093-1107.
[16] Pannacciulli N,De Pergola G,Ciccone M,et al.Effect of family historyof type 2 diabetes on the intima-media thickness of the common carotid arteryin normal-weight,overweight,and obese glucose-tolerant young adults[J].Diabetes Care,2003,26(4):1230-1244.
[17] Abd El-hafez H,Elrakhawy MM,El-baiomy AA,et al.Carotid intima media thickness is independently associated with male gender,middle age,and IGF-1in metabolically healthy obese individuals[J].ISRN Obesity,2014(2014):545804.
[18] 母春华,李薇薇,杨国锐,等.乐亭县敬老院老年男性踝臂指数与心血管疾病危险因素的关系[J].中国循证心血管医学杂志,2014,6(5):594-596. Mu CH,Li WW,Yang GR,et al.Relationship between ankle-brachial index and risk factors cardiovascular diseases in elderly male patients in gerocomium of laoting County[J].Chinese Journal of Evidence Based Medicine,2014,6(5):594-596.
[19] Thejaswini KO,Roopakala MS,Dayananda G,et al.A study of associationof ankle brachial index(ABI)and the highly sensitive C-reactive protein(hsCRP)in type 2 diabetic patients and in normal subjects[J].Journal of Clinical &Diagnostic Research,2013,7(1):46-50.
[21] Elias-smale SE,Kardys I,Oudkerk M,et al.C-reactive protein is related to extent and progression of coronary and extra-coronary atherosclerosis; results from the Rotterdam study[J].Atherosclerosis,2007,195(2):195-202.

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备注/Memo

备注/Memo:

作者简介:刘彦君(1982-),女,本科,主治医师,主要研究方向为内分泌、糖尿病,Tel:18691710017,E-mail:liuyanjun198203@163.com。 通信作者:庞晓宁,女,主治医师,E-mail:936411283@qq.com。
更新日期/Last Update: 2017-04-10