摘要
目的探讨血清糖化白蛋白(GA)、内源性分泌型终末糖化产物受体(esRAGE)、炎症因子C-反应蛋白(CRP)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平与糖尿病冠状动脉弥漫病变的关系。方法根据冠状动脉造影结果及有无糖尿病将374例患者分成五组:冠状动脉局灶病变组(Ⅰ组,n=107)、冠状动脉弥漫病变组(Ⅱ组,n=94)、单纯糖尿病组(Ⅲ组,n=46)、2型糖尿病合并冠状动脉局灶病变组(Ⅳ组,n=46)及2型糖尿病合并冠状动脉弥漫病变组(Ⅴ组,n=81),分别检测各组患者血清GA、esRAGE、高敏CRP(hsCRP)、IL-6和TNF-α的水平。结果Ⅴ组的GA和hsCRP水平最高,而esRAGE水平最低,与其他四组比较差异均有统计学意义(P<0.01)。Ⅳ组的GA和hsCRP高于Ⅰ～Ⅲ组,而esRAGE水平则均低于Ⅰ～Ⅲ组(P<0.05)。糖尿病患者中,GA水平与hsCRP和糖化血红蛋白(HbA1c)值呈正相关(r=0.249、0.695),与esRAGE呈负相关(r=-0.480)(均P<0.001);而esRAGE与HbA1c、hsCRP均呈负相关(r=-0.224、-0.236)(P<0.01)。2型糖尿病合并冠心病患者中,hsCRP与冠状动脉弥漫病变支数呈正相关(r=0.220,P<0.001);hsCRP和IL-6与空腹血糖水平均呈正相关(r=0.259,P<0.001;r=0.124,P<0.05)。结论糖尿病患者血清GA和hsCRP水平升高、esRAGE水平降低不仅是糖尿病并发冠心病的重要危险因子,也是反映糖尿病冠状动脉广泛弥漫和严重病变的重要指标。
Objective To investigate the relationship between serum glycated albumin （GA）, endogenous secretory receptor for advanced glycation end-products （esRAGE）, C-reactive protein （CRP）, intedeukin （IL）-6, tumor necrosis factor （TNF）-ct and diffuse coronary artery disease （CAD） in patients with diabetes mellitus. Methods Based on angiographic features and presence of diabetes mellitus, 374 patients with CAD were divided into group Ⅰ （focal CAD without diabetes mellitus, n = 107）, group Ⅱ （ diffuse CAD without diabetes mellitus, n = 94）, group Ⅲ （ diabetes mellitus without CAD, n = 46）, group Ⅳ（focal CAD with diabetes mellitus, n = 46） and group V （diffuse CAD with diabetes mellitus, n = 81）. Serum levels of GA, esRAGE, high-sensitivity CRP （hsCRP）, TNF-α and IL-6 were detected in each group. Results The serum levels of GA and hsCRP were the highest and esRAGE were the lowest in group Ⅴ, significantly different from those in the other four groups （P 〈 0.01）. The serum levels of GA and hsCRP were significantly higher and esRAGE were significantly lower in group Ⅳ than those in group Ⅰ , Ⅱ and Ⅲ （P 〈 0.05）. GA was positively correlated with hsCRP （r = 0. 240） and HbAlc （r = 0. 695）, and was negatively correlated with esRAGE （r = -0. 480） in patients with diabetes mellitus （P 〈 0. 001 for all）, while esRAGE was negatively correlated with HbAlc （r = -0. 224, P 〈 0.01） and hsCRP （r = - 0. 236, P 〈 0.01）. HsCRP was positively correlated with diffuse coronary vessels （ r = 0. 220, P 〈 0. 001）, and hsCRP as well as IL-6 were positively correlated with fasting blood glucose（ r = 0. 259, P 〈 0. 001; r = 0. 124, P 〈 0.05） in patients witil CAD and diabetes mellitus. Conclusion The increased serum GA and hsCRP levels and decreased serum esRAGE level are important risk factors for diabetes mellitus complicated with CAD, and are vital parameters for diffuse CAD in patients with diabetes mellitus.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2009年第5期565-568,共4页
Journal of Shanghai Jiao tong University:Medical Science
关键词
糖尿病
冠心病
糖化白蛋白
内源性分泌型终末糖化产物受体
炎症因子
diabetes mellitus
coronary artery disease
glycated albumin
endogenous secretory receptor for advanced glycation end products
inflammatory factor
