2型糖尿病病人血清趋化素水平与腹型肥胖及大血管病变的关系

贾笑迪; 裴晓艳; 汪琼; 于磊; 庄兰艮; 金国玺

doi:10.13898/j.cnki.issn.1000-2200.2021.05.010

2型糖尿病病人血清趋化素水平与腹型肥胖及大血管病变的关系

Relationship among serum chemerin level, abdominal obesity and diabetic macroangiopathy in patients with type 2 diabetes mellitus

摘要

摘要:
目的探讨2型糖尿病（T2DM）病人血清趋化素水平与动脉粥样硬化发生发展的关系。
方法选取T2DM病人117例，根据颈动脉内中膜厚度（CIMT）分组，分为CIMT正常组55例和CIMT增厚组62例；根据内脏脂肪面积（VFA）分组，分为腹型肥胖组49例和非腹型肥胖组68例。所有研究对象记录体质量指数（BMI）、收缩压（SBP）、舒张压（DBP）；检测空腹血糖（FBS）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、C反应蛋白（CRP）等；采用酶联免疫吸附法测定血清趋化素浓度，采用生物电阻抗测试法测量腹部内脏脂肪面积（VFA）和腹部皮下脂肪面积（SFA）。比较2组之间观察指标的差异，Pearson相关分析血清趋化素水平与各观察指标的相关性，二元logistics回归分析VFA、CIMT增厚的相关因素。
结果与CIMT正常组比较，CIMT增厚组TC、TG、FINS、HOMA-IR、DBP、SBP、VFA、趋化素、SFA均升高（P < 0.01）；与非腹型肥胖组比较，腹型肥胖组TC、TG、HOMA-IR、DBP、SBP、SFA、趋化素、CIMT均升高（P < 0.05）。相关分析结果显示，T2DM病人血清趋化素与SBP、DBP、TC、TG、BMI、FINS、HOMA-IR、VFA、SFA、CIMT均呈正相关关系（r=0.277、0.303、0.295、0.299、0.567、0.317、0.380、0.795、0.903、0.565，P < 0.01）。二元logistic回归分析结果显示，VFA、趋化素、FINS、SFA是CIMT的影响因素（P < 0.05~P < 0.01）；趋化素、SFA、HOMA-IR、CIMT是VFA的独立影响因素（P < 0.05）。
结论趋化素能够促进T2DM病人CIMT增厚，是一种危险因素，参与T2DM病人动脉粥样硬化的发生、发展。

Abstract:
ObjectiveTo explore the relationship between serum chemerin level in patients with type 2 diabetes mellitus(T2DM) and the development and progression of atherosclerosis.
MethodsA total of 117 T2DM patients were selected.Based on carotid intima-media thickness(CIMT), they were divided into CIMT normal group(n=55) and CIMT thickening group(n=62).Based on visceral fat area(VFA), all the patients were divided into was divided into the abdominal obesity group(n=49), and non-abdominal obesity group(n=68).All study subjects had been recorded including their body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP).Moreover, fasting blood glucose(FBS), fasting insulin(FINS), triglycerides(TG), total cholesterol(TC), low-density lipoprotein-cholesterol(LDL-C), high-density lipoprotein-cholesterol(HDL-C), glycosylated hemoglobin(HbA1c), C-reactive protein(CRP) and other indicators were detected.Furthermore, the serum chemerin concentrations were determined by the enzyme-linked immunosorbent assay, and the abdominal VFA and abdominal subcutaneous fat area(SFA) were measured by the bio-electrical inpedance analysis method.The differences of observation indexes between the two groups were compared.Pearson correlation analysis was conducted to explore the correlation between serum chemerin levels and the observation indexes.Binary logistics regression analysis was performed on the related factors of VFA and CIMT thickening.
ResultsCompared with the CIMT normal group, the TC, TG, FINS, HOMA-IR, DBP, SBP, VFA, chemerin and SFA were all increased in the CIMT thickening group(P < 0.01).Compared with the non-abdominal obesity group, TC, TG, HOMA-IR, DBP, SBP, SFA, chemerin and CIMT was increased in the abdominal obesity group(P < 0.05).The results of correlation analysis showed that serum chemerin levels in patients with T2DM were positively correlated with SBP, DBP, TC, TG, BMI, FINS, HOMA-RI, VFA, SFA and CIMT(r=0.277, 0.303, 0.295, 0.299, 0.567, 0.317, 0.380, 0.795, 0.903, 0.565, P < 0.01).The results of binary logistic regression analysis showed that VFA, chemerin, FINS and SFA were the related factors of CIMT(P < 0.05 to P < 0.01);chemerin, SFA, HOMA-IR and CIMT were the related factors of VFA(P < 0.05).
ConclusionsChemerin can promote the thickening of CIMT in patients with T2DM, which is a risk factor participating in the occurrence and development of atherosclerosis for patients with T2DM.

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