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目的:探讨visfatin与老年2型糖尿病及其大血管并发症和相关代谢指标的关系。方法:将66例老年糖尿病患者分为合并大血管病变组(MCV)35例和非大血管病变组(nMCV)31例,并选64例健康人做对照。采取酶联免疫测定法(ELISA)测定空腹血清visfatin浓度;并测定各组的空腹血糖、胰岛素、血压和血脂水平;用胰岛素抵抗指数(HO-MA-IR)HOMA-IR评价胰岛素抵抗,分析各指标间的相关性及与大血管并发症的相关性。结果:①老年2型糖尿病组血清visfatin浓度高于正常对照组,差异有统计学意义(P<0.01)。但正常对照组与2型糖尿病组中nMCV组比较,visfatin浓度差异无统计学意义(P>0.05)。②老年2型糖尿病组中大血管病变组(MCV)血清visfatin浓度明显高于非大血管病变组(nMCV),差异有统计学意义(P<0.01)。③相关分析显示,老年2型糖尿病组血清visfatin浓度与腰围(WC)、甘油三酯(TG)均呈显著正相关,与性别、年龄、HOMA-IR呈正相关。进一步以visfatin为应变量,以年龄、性别、BMI、WC、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、空腹胰岛素(FINS)、HOMA-IR为自变量进行多元逐步回归分析,TG、WC和年龄是血清visfatin独立相关因素。④在老年T2DM组,以有无大血管并发症为应变量(Y=1,n=0),各指标为自变量,进行logistic回归分析,visfatin进入回归方程。结论:血清visfatin与2型糖尿病的发病不相关,但在老年2型糖尿病中与其大血管并发症有关。
Objective: To investigate the relationship between visfatin and elderly type 2 diabetes and its macrovascular complications and related metabolic parameters. Methods: Sixty-six elderly patients with diabetes were divided into 35 patients with macrovascular disease (MCV) and 31 patients with non-macrovascular disease (nMCV), and 64 healthy people were selected as controls. Fasting serum visfatin levels were determined by enzyme-linked immunosorbent assay (ELISA); fasting blood glucose, insulin, blood pressure and blood lipid levels were measured in each group; insulin resistance was evaluated by HOMA-IR with insulin resistance index (HO-MA-IR) Correlation between indicators and the correlation with macrovascular complications. Results: ① The serum visfatin concentration in the elderly type 2 diabetes mellitus group was higher than that in the normal control group (P <0.01). However, there was no significant difference in the concentration of visfatin between normal control group and type 2 diabetes mellitus group (P> 0.05). (2) Serum visfatin concentrations in MCV group were significantly higher than those in non-MCM group (P <0.01). ③ Correlation analysis showed that there was a significant positive correlation between serum visfatin concentration and waist circumference (WC) and triglyceride (TG) in elderly type 2 diabetic patients, and positively correlated with gender, age and HOMA-IR. Further, visfatin was used as a measure to measure the changes of serum LDL-C level by age, gender, BMI, WC, SBP, DBP, TC, TG, HDL-C, FPG, FINS and HOMA-IR were used as independent variables. TG, WC and age were independent factors of serum visfatin. ④ In the elderly T2DM group, the presence or absence of macrovascular complications as a dependent variable (Y = 1, n = 0), the indicators as independent variables, logistic regression analysis, visfatin into the regression equation. Conclusion: Serum visfatin is not related to the incidence of type 2 diabetes mellitus, but is associated with its macrovascular complications in type 2 diabetes mellitus.