老年2型糖尿病患者血清脂联素和动脉粥样硬化的 - 第三军医大学学报.doc

老年2型糖尿病患者血清脂联素和早期动脉粥样硬化的关系 杨缙 邓华聪 廖璞(重庆医科大学附属第一医院内分泌科，重庆400016； 重庆市第三人民医院老年科，重庆400014) [摘要] 目的 分析老年2型糖尿病患者血清脂联素水平和早期动脉粥样硬化的关系。 方法 将55例老年2型糖尿病患者根据颈动脉内膜中层厚度（carotid intima-media thickness,CIMT）进行分组，29例CIMT≤0.9mm的2型糖尿病患者为非动脉粥样硬化组，另外26例CIMT0.9mm或发现动脉斑块的2型糖尿病患者为动脉粥样硬化组，并配对选取25例非糖尿病的健康者为对照组。同时收集入选者的临床资料，包括年龄、性别、体重指数（BMI）、踝臂指数（ABI）、糖化血红蛋白（HbA）、血糖、空腹血脂以及胰岛素等生化指标，并计算稳态模型（Homa Model）的胰岛素抵抗指数Homa IR =（FINS × FPG）/ 22. 5，取其自然对数值；用酶联免疫法测定入选者的血清脂联素。 结果 （1）动脉粥样硬化组的血清脂联素显著低于非动脉粥样硬化组及对照组。（2）相关性研究显示脂联素与血糖、HbA、高敏C反应蛋白（hs-CRP）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、CIMT负相关，而与高密度脂蛋白胆固醇（HDL-C）、踝臂指数正相关。（3）多元逐步回归分析显示低密度脂蛋白胆固醇与高密度脂蛋白胆固醇是影响血清脂联素水平的独立因素。 结论 在老年2型糖尿病患者中，血清脂联素降低与动脉粥样硬化密切相关。 关键词 2型糖尿病 脂联素 颈总动脉内中膜厚度 动脉粥样硬化 Study on serum adiponectin and Early Atherosclerosis in the aged patients with type 2 diabetes mellitus YANG Jin，DENG Hua-cong，LIAO Pu. Department of Endocrinology,The First Affiliated Hospital of Chongqing Medical University ,Chongqing 400016, Department of Gereology,The Third People’s Hospital of Chongqing , Chongqing 400014) [Abstract] Objective To study the relation between serum adiponectin and early atherosclerosis in the aged patients with type 2 diabetes mellitus (DM). Methods Fifty-five the aged type 2 diabetic patients ( diagnosed according to the World Health Organization criteria ) were involved in this study. The patients were divided into two groups according to the carotid intima-media thickness(CIMT): 29 patients with CIMT≤0.9mm ( as DM unwith Atherosclerosis ), 26 patients with CIMT0.9mm ( as DM with Atherosclerosis ),and another 25 non-diabetic matched individuals were recruited as control group. Collecting the subject clinical data,CIMT was assessed by the high –resolution B-mode ultrasound unit and adiponectin was measured by ELISA . Results (1)In categorical analyses, the mean level of serum adiponectin in subjects of DM-with Atherosclerosis was significantly lower than that in the other groups (P0.01). (2) Adiponectin was negatively corre