【摘要】 目的 探讨2型糖尿病(T2DM)患者血清Clq/TNF相关蛋白3(Clq tumor necrosis factor related protein 3,CTRP3),Clq/TNF相关蛋白9(Clq tumor necrosis factor related protein 9,CTRP9)与动脉粥样硬化病变(atherosclerosis,AS)的相关性。方法 随机选取2014年1月~2015年1月陕西省人民医院内分泌科住院的成人新发T2DM患者196例,入选T2DM组,并根据颈动脉彩色多普勒超声结果将其分为糖尿病伴动脉粥样硬化组(AS组,71例)和单纯糖尿病组(非AS组,125例),另外随机选取同期健康体检者152例作为正常对照组,测定所有受试者的体重指数(BMI),腰围(WC),臀围(HIP),腰臀比(WHR),收缩压(SBP),舒张压(DBP),空腹血糖(FBG),餐后2h血糖(2hPBG),糖化血红蛋白(HBAlc),三酰甘油(TG),总胆固醇(TC),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C),CTRP3及CTRP9。结果①T2DM组血清与正常对照组比较CTRP3(0.67±0.34 ng/ml vs 0.99±0.32 ng/ml),CTRP9(9.04±3.11 ng/ml vs12.11±2.89 ng/ml),HDL-C(1.48±0.27 mmol/L vs 1.23±0.57 mmol/L),FBG(4.62±0.53 mmol/L vs 9.41±2.61mmol/L),2hPBG(5.90±0.80 mmol/L vs 11.55±3.20 mmol/L),HBAlc(4.86±0.45 mmol/L vs 8.79±2.14 mmol/L),LDL-C(2.48±0.36 mmol/L vs 3.58±0.89 mmol/L),TC(3.64±1.10 mmol/L vs 5.77±0.97 mmol/L),TG(1.23±0.34mmol/L vs 1.71±0.75 mmol/L)差异有统计学显著性意义(t=-13.069~5.88,P值均<0.01)。②AS组与非AS组比较CTRP3(0.67±0.34 ng/ml vs 0.99±0.32 ng/ml),CTRP9(9.04±3.11 ng/ml vs 12.11±2.89 ng/ml),年龄(55.82±8.80岁vs 62.49±6.54岁)差异有统计学显著性意义(t/x~2=0.036~7.345,P值均<0.01),两组血清TC(5.61±0.90mmol/L vs 6.05±1.02 mmol/L),LDL-C(3.44±0.80 mmol/L vs 3.83±1.01 mmol/L)差异亦有统计学显著性意义(t=-2.083~-2.197,P值均<0.05)。③相关性研究:CTRP3与WC(r=-0.932),DBP(r=-0.932),FBG(r=-0.856),TG(r=-0.728),TC(r=-0.920)呈负相关(P值均<0.01),CTRP9和年龄(r=-0.958)呈负相关(P值均<0.01),与HDL-C(r=0.860)呈正相关(P<0.01)。④多元逐步回归分析:WC,DBP,FBG是CTRP3的独立危险因子(P<0.01),年龄,HDL-C是CTRP9的独立危险因子(P<0.01)。结论 CTRP3,CTRP9可能具有抗动脉粥样硬化作用,是糖尿病动脉粥样硬化的保护因子。更多还原

【Abstract】 Objective To explore the reletionship between C1q/TNF-related protein-3(CTRP3),Clq/TNF-related protein-9(CTRP9) and artery atherosclerosis(AS) in the patients with type 2 diabetes(T2DM).Methods Collected clinical datas of adults with patients with new type 2 diabetic who were in endocrinology department of Shaanxi Provincial People’s Hospital from January 2014 to January 2015 enrolled 196 cases of T2 DM group,and according to the results of carotid color Doppler ultrasound were divided into diabetic patients with atherosclerosis group(AS group,71 cases) and diabetes alone group(non-AS group,125 cases),and then randomly selected 152 cases of healthy volunteers as normal control group,all subjects measured body mass index(BMI),waist circumference(WC),hip circumference(HIP),waist-hip ratio(WHR),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPBG).glycated hemoglobin(HBAlc),triglycerides(TG),total cholesterol(TO,high density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),CTRP3 and CTRP9.Results ① The difference of serum CTRP3(0.67 ± 0.34 ng/ml vs 0.99 ±0.32 ng/ml),CTRP9(9.04 ±3.11 ng/ml vs 12.11 ±2.89 ng/ml),HDL-C(1.48 ± 0.27mmol/L vs 1.23 ± 0.57 mmol/L),FBG(4.62±0.53 mmol/L vs 9.41±2.61 mmol/L),2hPBG(5.90±0.80 mmol/L vs11.55±3.20 mmol/L),HBA1c(4.86±0.45 mmol/L vs 8.79±2.14 mmol/L),LDL(2.48±0.36 mmol/L vs 3.58±0.89mmol/L),TC(3.64±1.10 mmol/L vs 5.77 ±0.97 mmol/L),TG(1.23 ±0.34 mmol/L vs 1.71±0.75 mmol/L)(/=-13.069 — 5.88,P all<0.01) in T2 DM group and normal control group were significant.②The difference of serum CTRP3(0.67 ± 0.34 ng/ml vs 0.99 ± 0.32 ng/ml),CTRP9(9.04 ± 3.11 ng/ml vs 12.11 ± 2.89 ng/ml),the age(55.82 ± 8.80 year vs 62.49 ± 6.54 year)(t/x~2 =0.036 — 7.345,P all<0.01),TC(5.61 ± 0.90 mmol/L vs 6.05±1.02 mmol/L),LDL-C(3.44 ± 0.80 mmol/L vs 3.83 ± 1.01 mmol/L)(t=-2.083~-2.197,P all<0.05) in T2 DM group and non-AS group were significant.Serum levels of TC(5.61 ± 0.90 mmol/L vs 6.05 ± 1.02 mmol/L),LDL-C(3.44 ± 0.80 mmol/L vs 3.83±1.01 mmol/L) difference were also statistically significant(t=-2.083~-2.197,P all<0.05).③CTRP3 negatively correlated with WC(r=-0.932),DBP(r=- 0.932),FBG(r=- 0.856),TG(r=-0.728),TC(r=-0.920)(P<0.01).CTRP9 negatively correlated with age(r= — 0.958),positively correlated with HDL-C(r=0.860)(P<0.01).④Multiple Stepwise regression analysis showed that WCDBP.FBG would be independent risk factors of CTRP3(P<0.01)and the age,HDL-C would be independent risk factors of CTRP9(P<0.01).Conclusion CTRP3,CTRP9 may have antiatherosclerotic effect,is diabetic atherosclerosis protection factor.更多还原