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目的探讨糖尿病足溃疡(DFU)患者血清视黄醇结合蛋白4(RBP4)的水平及其临床意义。方法 将2013年1月至2015年3月于临沂市河东区人民医院住院的158例T2DM患者分为单纯糖尿病组(DM组)80例和DFU组78例;再将DFU组按照Wagner分级标准和是否合并感染进行分级、分组;另取我院查体血糖正常的健康人80名作为对照组(NC组)。记录3组性别、年龄、糖尿病病程、BP、BMI、吸烟指数,测定FPG、2 hPG、HbA_1c、TG、TC、HDL-C、LDL-C、RBP4、同型半胱氨酸(Hcy)、高敏C反应蛋白(hsC-RP)、肝肾功能等指标,并对结果进行统计学分析。结果 (1)DFU组RBP4水平高于DM组和NC组[(105.61±17.48)vs(78.29±16.81)vs(53.27±15.92)mg/L](P<0.01);(2)随Wagner分级的增加,RBP、Hcy、hsC-RP水平逐渐升高(P<0.05);(3)合并感染DFU亚组(IDFU亚组)RBP4水平高于无感染DFU亚组(NIDFU亚组)[(112.58±21.86)vs(83.72±16.34)mg/L](P<0.01)。(4)Spearman相关分析显示,DFU患者血清RBP4的水平与TG、LDL-C、HbA_1c、SBP、糖尿病病程、吸烟指数呈正相关。(5)Logistic回归分析显示,RBP4、Hcy是DFU的危险因素。结论 DFU患者RBP4水平升高,并与其严重程度及是否感染相关;RBP4的水平与TG、LDL-C、HbA_1c、糖尿病病程、吸烟指数呈正相关。
Objective To investigate the serum level of retinol binding protein 4 (RBP4) in patients with diabetic foot ulcer (DFU) and its clinical significance. Methods A total of 158 T2DM patients hospitalized in Hedong District People’s Hospital of Linyi City from January 2013 to March 2015 were divided into two groups: 80 cases in DM group and 78 cases in DFU group. According to Wagner grading standard and Whether the infection was graded, grouping; another 80 normal healthy people in our hospital physical examination as a control group (NC group). The gender, age, duration of diabetes, BP, BMI and smoking index were recorded and the plasma levels of FPG, 2 hPG, HbA 1 c, TG, TC, HDL-C, LDL-C, RBP4, Hcy, Reaction protein (hsC-RP), liver and kidney function and other indicators, and the results were statistically analyzed. Results (1) The level of RBP4 in DFU group was higher than that in DM group and NC group (105.61 ± 17.48 vs 78.29 ± 16.81 vs 53.27 ± 15.92 mg / L, respectively) (P <0.01) The level of RBP4 in DFU subgroup (IDFU subgroup) was higher than that in non-infected DFU subgroup (NIDFU subgroup) [(112.58 ± 21.86) vs (83.72 ± 16.34) mg / L] (P <0.01). (4) Spearman correlation analysis showed that the level of serum RBP4 in DFU patients was positively correlated with TG, LDL-C, HbA 1c, SBP, duration of diabetes and smoking index. (5) Logistic regression analysis showed that RBP4 and Hcy were risk factors of DFU. Conclusions The level of RBP4 in DFU patients is elevated and related to the severity and infection. The level of RBP4 is positively correlated with TG, LDL-C, HbA 1c, duration of diabetes and smoking index.