摘要
目的:观察2型糖尿病合并视网膜病变(DR)患者血清炎症因子和脂联素的变化。方法:110例糖尿病患者分为3组:糖尿病无视网膜病变组(DM)35例、糖尿病伴非增殖期视网膜病变组(NPDR)45例和糖尿病伴增殖期视网膜病变组(PDR)30例,并与40名正常人对照(NC组)。观察患者的体检指标,并检测空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、餐后2 h血糖(2hPG),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)、脂联素、血清细胞间黏附分子-1(ICAM-1)、肿瘤坏死因子-α(TNF-α)和高敏C-反应蛋白(hs-CRP)。计算稳态模型评估的胰岛素抵抗指数(HOMA-IR)。结果:DM组、NPDR组和PDR组患者的收缩压、体重指数、腰臀比、血清TG、LDL-C、FPG、2hPG、HbA1c、ICAM-1、TNF-α、hs-CRP水平和HOMA-IR均高于NC组(P<0.05),而NPDR组和PDR组的收缩压、血清ICAM-1、TNF-α、hs-CRP水平和HOMA-IR均高于DM组(P<0.05)。DM组、NPDR组及PDR组的患者血清脂联素水平均低于NC组(P<0.05),而NPDR组及PDR组的患者血清脂联素水平低于DM组患者(P<0.05)。血清脂联素水平与ICAM-1、TNF-α、hs-CRP和HOMA-IR之间呈负相关(r值分别为-0.735、-0.781、-0.768、-0.752,均P<0.01),HOMA-IR与ICAM-1、TNF-α和hs-CRP之间呈正相关(r值分别为0.857、0.906、0.888,均P<0.01)。结论:炎症因子和脂联素参与了DR的发生和发展,而脂联素可能通过拮抗炎症反应减轻胰岛素抵抗,对DR有一定的改善作用。
AIM：To investigate the serum levels of inflammatory factors and adiponectin in type 2 diabetic retinopathy（DR） patients.METHODS： One hundred and ten cases of type 2 diabetic patients were divided into 3 groups： no diabetic retinopathy group（DM,n=35）,non-proliferative diabetic retinopathy group（NPDR,n=45）,and proliferative diabetic retinopathy group（PDR,n=30）.Other 40 normal persons served as controls（NC group）.The physical examinated was performed for each patient.Serum levels of fasting plasma glucose（FPG）,glycated hemoglobin A1c（HbA1c）,2 h postprandial plasma glucose （2hPG）,fasting insulin（FINS）,total cholesterol（TC）,triglyceride（TG）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）,adiponectin,intercellular adhesion molecule-1（ICAM-1）,tumor necrosis factor-α（TNF-α） and high-sensitivity C-reactive protein（hs-CRP） were measured.Insulin resistance index（HOMA-IR） was also calculated.RESULTS： The systolic blood pressure,body-mass index,waist-hip ratio,serum levels of TG,LDL-C,FPG,2hPG,HbA1c,ICAM-1,TNF-α,hs-CRP and HOMA-IR were significantly higher in DM group,NPDR group and PDR group than those in NC group（P0.05）.The systolic blood pressure,serum levels of ICAM-1,TNF-α,hs-CRP and HOMA-IR were higher in NPDR group and PDR group than those in DM group（P0.05）.The serum concentration of adiponectin was lower in DM group,NPDR group and PDR group than that in NC group（P0.05）,and that was also lower in NPDR group and PDR group than that in DM group（P0.05）.The negative correlations between adiponectin and ICAM-1（r=-0.735,P0.01）,TNF-α（r=-0.781,P0.01）,hs-CRP（r=-0.768,P0.01） or HOMA-IR（r=-0.752,P0.01） were observed.The relationships between HOMA-IR and ICAM-1（r=0.857,P0.01）,TNF-α（r=-0.906,P0.01） or hs-CRP（r=-0.888,P0.01） were positive.CONCLUSION： The results suggest that inflammatory refactors and adiponectin play important roles in the pathophysiology and progres
出处
《中国病理生理杂志》
CAS
CSCD
北大核心
2011年第6期1154-1158,共5页
Chinese Journal of Pathophysiology
基金
广东省自然科学基金资助项目(No.9151008901000092)
