血清胎球蛋白A水平与胰岛素抵抗及颈动脉内膜中层厚度在初诊2型糖尿病患者中的相关性分析

Association of fetuin-A level with insulin resistance and carotid intima-media thickness in patients with newly-diagnosed type 2 diabetes mellitus

摘要:

旨在探讨初诊2 型糖尿病（nT2DM）患者血清胎球蛋白A（FA）水平与胰岛素抵抗（IR）及颈动脉内膜中层厚度（CIMT）的相关性。方法选取nT2DM 患者100 例作为病例组（T2DM 组），糖耐量正常（NGT）者100 例作为对照组（NGT 组），采用酶联免疫吸附实验（ELISA 法）试剂盒检测血清FA 浓度，计算稳态模型胰岛素抵抗指数（HOMA-IR）评估IR，运用彩色超声诊断仪测定CIMT，分析血清FA 浓度与各项临床资料之间的相关性。结果T2DM 组血清FA 水平（368.5±15.6）mg/ml 高于NGT 组血清FA 水平（152.7±7.1）mg/ml，差异有统计学意义（p =0.000）；FA 水平与HOMA-IR（r =0.483，p =0.000）、CIMT（r = 0.509，p = 0.000）、糖化血红蛋白（HbA1c）（r =0.153，p =0.042）、三酰甘油（TG）（r =0.353，p =0.000）、低密度脂蛋白 （LDL-C）（r =0.113，p =0.023）、体重指数（BMI）（r =0.162，p =0.024）、收缩期血压（SBP）（r =0.182，p =0.035）、空腹血糖（FPG）（r = 0.422，p =0.002）及2 h 葡萄糖负荷血糖（2 h OGTT）（r =0.581，p =0.000）呈正相关，与空腹血浆胰岛素（FINS）（r =-0.153，p =0.008）、2 h 葡萄糖负荷血浆胰岛素（PINS）（r =-0.423，p =0.008）、高密度 脂蛋白（HDL-C）（r =-0.183，p =0.011）和HOMA-β细胞胰岛素分泌指数（HOMA-IS）（r =-0.463，p =0.000）呈负相关结论nT2DM 患者血清FA 水平与IR及CIMT之间存在相关性，研究结果表明，血清FA 水平可作为诊断nT2DM 患者大血管病变的独立生物学标志物。

Abstract:

To investigate the correlations of fetuin-A (FA) level with insulin resistance (IR) and carotid intima-media thickness (CIMT) in patients with newly-diagnosed type 2 diabetes mellitus (nT2DM). Methods One hundred cases of nT2DM patients were selected as experimental group (T2DM group) while 100 people with normal glucose tolerance (NGT) as control group (NGT group). Serum FA level was measured by a commercial solidphase ELISA kit. The estimation of IR was calculated by homeostasis model assessment (HOMA-IR). CIMT was measured by color B-mode ultrasound. The correlations of serum fetuin-A level with the metabolic parameters were also analyzed. Results The serum FA level in the T2DM group was significantly higher than that in the NGT group [(368.5 ±15.6) vs (152.7 ±7.1) mg/ml,p = 0.000]. Serum FA level was positively correlated with HOMA-IR (r =0.483,p = 0.000), CIMT (r = 0.509,p = 0.000), glycated hemoglobin (r = 0.153, p= 0.042), triglyceride (r = 0.353,p=0.000)low-density lipoprotein cholesterol (r = 0.113,p = 0.023), body mass index (r = 0.162,p = 0.024),systolic blood pressure (r = 0.182, p= 0.035), fasting plasma glucose (r = 0.422, p= 0.002) and 2-h post-glucose load blood glucose (r = 0.581,p = 0.000); but negatively correlated with fasting plasma insulin (r = -0.153, p= 0.008), 2-h plasma insulin after glucose load (r = -0.423,p = 0.008), high-density lipoprotein cholesterol (r = -0.183,p= 0.011) and HOMA-β-cell insulin secretion index (r = -0.463, p= 0.000). Conclusions The study demonstrated that serum FA level is correlated with IR and CIMT in patients with nT2DM. Therefore, serum FA level can be used as an independent marker in the diagnosis of macroangiopathies in patients with nT2DM.