血清成纤维细胞生长因子-21水平与2型糖尿病患者下肢动脉粥样硬化关系

doi:10.13217/j.scjpm.2019.0323

摘要/Abstract

摘要： 目的探讨血清成纤维细胞生长因子-21（FGF-21）水平与2型糖尿病患者下肢动脉粥样硬化的关系。方法以2017年11月至2018年9月在重庆大足区人民医院临床确诊的2型糖尿病患者为研究对象,对患者体格项目及血生化指标进行检测,并测定患者的下肢动脉内-中膜厚度（IMT）。比较粥样硬化2型糖尿病患者和非粥样硬化糖尿病患者指标差异,并采用多元线性回归方法分析IMT与血清FGF-21的相关性。结果共纳入2型糖尿病患者121例,无粥样硬化组69例,粥样硬化组52例,粥样硬化发生比例为43.0%。2组病例男性分别为42、31例,女性分别为27、21例,性别构成差异无统计学意义（P>0.05）。粥样硬化组病程和腰臀比均大于无粥样硬化组（均P<0.01）,平均年龄、BMI、收缩压、舒张压差异无统计学意义（均P>0.05）。粥样硬化2型糖尿病患者空腹血糖（FBG）、甘油三酯、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）、IMT、FGF-21均高于非粥样硬化患者（均P<0.01）。相关分析结果显示IMT与腰臀比、FBG、HbA1c、HOMA-IR、FGF-21呈正相关关系（r=0.271、0.319、0.322、0.372、0.265,P<0.05）。多元线性回归分析显示腰臀比、FBG、FGF-21是IMT的影响因素（标准偏回归系数=0.194、0.341、0.657）。结论 2型糖尿病患者IMT与腰臀比、FBG、FGF-21有关。血清FGF-21水平升高,可能对2型糖尿病患者下肢动脉粥样硬化的形成产生了作用。

关键词: 2型糖尿病, 成纤维细胞生长因子-21, 动脉粥样硬化, 下肢

Abstract: Objective To investigate the relationship between serum fibroblast growth factor 21 （FGF21） level and lower extremity atherosclerosis in type 2 diabetic patients. Methods Patients with type 2 diabetes diagnosed clinically in Dazu District People's Hospital of Chongqing from November 2017 to September 2018 were enrolled in the study. Anthropometric and blood biochemical parameters of the patients were tested and the intima-media thickness （IMT） of the lower extremity was measured. Differences between atherosclerotic type 2 diabetic patients and non-atherosclerotic diabetic patients were compared. Multivariable linear regression was used to analyze the correlation between IMT and serum FGF21. Results A total of 121 patients with type 2 diabetes were enrolled, including 69 patients without atherosclerosis and 52 patients with atherosclerosis. The prevalence rate of atherosclerosis was 43.0%. There were 42 and 31 males,and 27 and 21 females in the two groups, respectively （P>0.05）. The course of disease and waist-to-hip ratio in the atherosclerosis group were higher than those in the atherosclerosis-free group （P<0.01）. There were no significant differences in mean age, BMI, systolic blood pressure and diastolic blood pressure （P>0.05 for all）. Fasting blood glucose（FBG）, triglyceride, glycosylated hemoglobin（HbA1c）, insulin resistance index（HOMA-IR）, IMT and FGF21 in patients with atherosclerosis were higher than those in non-atherosclerotic patients （P<0.01 for all）. Correlation analysis showed that IMT was positively correlated with waist-to-hip ratio, FBG, HbA1c, HOMA-IR and FGF21 （r=0.271, 0.319, 0.322, 0.372, 0.265; P<0.05）. Multivariable linear regression model showed that waist-to-hip ratio, FBGand FGF21 were independent factors affecting IMT（Standard partial regression coefficient：0.194,0.341, 0.657,respectively）. Conclusion IMT in patients with type 2 diabetes was associated with waist-to-hip ratio, FBG and FGF21. Serum FGF21 levels may play a role in the formation of lower extremity atherosclerosis in patients with type 2 diabetes mellitus.

Key words: Type 2 diabetes, Fibroblast growth factor 21, Atherosclerosis, Lower extremity

中图分类号:

R587.1

何汉琴, 杨建军, 兰梅, 雷易, 韦用兰. 血清成纤维细胞生长因子-21水平与2型糖尿病患者下肢动脉粥样硬化关系[J]. 华南预防医学, 2019, 45(4): 323-326.

HE Han-qin, YANG Jian-jun, LAN Mei, LEI Yi, WEI Yong-lan. Relationship between serum fibroblast growth factor 21 level and lower extremity atherosclerosis in type 2 diabetic patients[J]. South China Journal of Preventive Medicine, 2019, 45(4): 323-326.

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