【摘要】 目的探讨载脂蛋白M(apoM)与2型糖尿病(T2DM)患者颈动脉粥样硬化(CAS)的关系。方法选择2015年1月至2018年1月本院收治的135例T2DM患者作为T2DM组,根据颈动脉内中膜厚度(IMT)分为IMT正常组(42例)、IMT增厚组(IMT介于0.9mm与1.2mm之间,39例)和斑块组(IMT>1.2mm,54例),并选择80例同期健康体检者作为对照组,比较T2DM组与对照组各临床指标,比较T2DM各组血清apoM水平,分析血清apoM水平与血脂指标、IMT的关系。结果 T2DM组与对照组年龄、性别、收缩压、甘油三酯(TG)、低密度脂蛋白(LDL-C)比较,差异无统计学意义(P>0.05),T2DM组体质量指数(BMI)、吸烟量、空腹血糖、餐后2h血糖、舒张压、胆固醇(TC)均高于对照组(P<0.05),高密度脂蛋白(HDL-C)、apoM均低于对照组(P<0.05);T2DM各组血清apoM水平均低于对照组(P<0.05),斑块组血清apoM水平明显低于IMT增厚组和IMT正常组(P<0.05),IMT增厚组血清apoM水平明显低于IMT正常组(P<0.05);相关性分析显示,T2DM患者血清apoM水平与TG、LDL-C无明显关系(P>0.05),与TC、HDL-C呈正相关(P<0.05),与IMT呈负相关(P<0.05);Logistic回归分析显示,apoM<16.85μg/mL是T2DM患者IMT增厚的危险因素(P<0.05)。结论 T2DM患者血清apoM明显呈低表达,apoM低表达可能是T2DM患者发生CAS的危险因素。更多还原

【Abstract】 Objective To explore the relationship between apolipoprotein M(apoM) and carotid atherosclerosis(CAS) in patients with type 2 diabetes mellitus(T2 DM). Methods A total of 135 cases of patients with T2 DM admitted to our hospital from January 2015 to January 2018 were chosen as T2 DM group and were divided into normal IMT group(42 cases), IMT thickening group(IMT ranged between 0.9 mm and 1.2 mm, 39 cases) and plaque group(IMT>1.2 mm, 54 cases) according to the carotid intima-media thickness(IMT). And 80 cases of healthy examiners at the same period were selected as control group. The clinical indicators were compared between T2 DM group and control group, and the serum apoM level of each T2 DM group was compared, and the relationship between serum apoM level and blood lipids indexes and IMT was analyzed. Results There was no significant difference in age, gender, systolic blood pressure, triglyceride(TG) and low density lipoprotein-cholesterol(LDL-C) between T2 DM group and control group(P>0.05), and the body mass index(BMI), smoking amount, fasting blood glucose, postprandial 2 h blood glucose, diastolic blood pressure and cholesterol(TC) in T2 DM group were higher than those in control group(P<0.05), and the high-density lipoprotein-cholesterol(HDL-C) and apoM were lower than those in control group(P<0.05). The serum apoM level in T2 DM group was higher than that in control group(P<0.05), and the serum apoM level in plaque group was significantly higher than that in IMT thickening group and normal IMT group(P<0.05), and the serum apoM level in IMT thickening group was significantly higher than that in normal IMT group(P<0.05). Correlation analysis showed that serum apoM level in T2 DM patients had no significant relationship with TG and LDL-C(P>0.05), and was positively correlated with TC and HDL-C(P<0.05), and was negatively correlated with IMT(P<0.05). Logistic regression analysis showed that apoM<16.85μg/mL was a risk factor for IMT thickening in T2 DM patients(P<0.05). Conclusion Serum apoM is significantly lowly-expressed in patients with T2 DM, and low apoM expression may be a risk factor for CAS in patients with T2 DM.更多还原