视黄醇结合蛋白4与早期2型糖尿病颈动脉病变的相关性分析

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目的探讨视黄醇结合蛋白4(RBP4)与早期2型糖尿病颈动脉病变的相关性。方法选取2014年4月-2015年4月来我院就诊的129例早期糖尿病患者,分为动脉粥样硬化(AS)组69例和非动脉粥样硬化(NAS)组60例,另选择60名健康体检者作为对照(NC)组。对比3组资料水平,分析RBP4与2型糖尿病的关系。结果 AS组及NAS组BMI、腰围、腰臀比显著高于NC组(P均<0.01);AS组BMI、腰围显著高于NAS组(P均<0.05);AS组腰臀比明显高于NAS组(P<0.01)。AS组、NAS组收缩压、舒张压显著高于NC组(均P<0.01)。AS组,NAS组的FPG、FINS、HOMA-IR、Hb A1c显著高于NC组(均P<0.01);AS组上述指标均明显高于NAS组(P<0.05)。AS、NAS、NC组的TC水平依次降低(P<0.05)。HDL-C在AS组,NAS组显著低于NC组(均P<0.01)。AS组LDL-C显著高于NC组、NAS组(均P<0.01)。AS组血清RBP4水平显著高于NC组,NAS组(均P<0.01);但NAS组与NC组比较差异无统计学意义。TC、LDL-C、FINs、HOMA-IR、收缩压、舒张压、BMI、腰围、腰臀比与RBP4呈正相关(r=0.210,0.135,0.289,0.245,0.339,0.237,0.253,0.286,0.170,P<0.05);与HDL-C呈负相关(r=-0.245,P<0.01)。所有研究对象按照有无动脉病变为因变量,以收缩压、Hb A1c、TC、LDL-C、RBP4等危险因素进行Logistic回归分析,结果发现动脉病变与RBP4、Hb A1c,收缩压正相关,是颈动脉病变的危险因素(OR分别为1.031、1.685、1.049,95%CI分别为1.005~1.058,1.297~2.038,1.026~1.076)。结论 RBP4水平与动脉粥样硬化显著相关,提示RBP4是颈动脉病变危险因素之一。 Objective To investigate the relationship between retinol binding protein 4 (RBP4) and carotid artery disease in type 2 diabetic patients. Methods A total of 129 patients with early-stage diabetes admitted to our hospital from April 2014 to April 2015 were divided into two groups: atherosclerosis (AS) group (69 cases) and non-atherosclerosis (NAS) group (60 cases) Healthy physical examination as a control (NC) group. The data of 3 groups were compared to analyze the relationship between RBP4 and type 2 diabetes mellitus. Results The BMI, waist circumference and waist-to-hip ratio in AS group and NAS group were significantly higher than those in NC group (P <0.01). The BMI and waist circumference in AS group were significantly higher than those in NAS group (all P <0.05) NAS group (P <0.01). The systolic and diastolic blood pressures of AS group and NAS group were significantly higher than those of NC group (all P <0.01). The levels of FPG, FINS, HOMA-IR and Hb A1c in NAS group were significantly higher than those in NC group (all P <0.01). The above indexes in AS group were significantly higher than those in NAS group (P <0.05). TC levels in AS, NAS and NC groups decreased in turn (P <0.05). HDL-C in AS group, NAS group was significantly lower than NC group (P <0.01). LDL-C in AS group was significantly higher than that in NC group and NAS group (all P <0.01). Serum RBP4 level in AS group was significantly higher than that in NC group and NAS group (all P <0.01). However, there was no significant difference between NAS group and NC group. The levels of TC, LDL-C, FINs, HOMA-IR, systolic blood pressure, diastolic blood pressure, BMI, waist circumference and WHR were positively correlated with RBP4 (r = 0.210,0.135,0.289,0.245,0.339,0.237,0.253,0.286,0.170, P <0.05), but negatively correlated with HDL-C (r = -0.245, P <0.01). Logistic regression analysis showed that there was a positive correlation between arterial disease and RBP4, Hb A1c and systolic blood pressure in all subjects according to the presence or absence of arterial disease as the dependent variable and systolic blood pressure, Hb A1c, TC, LDL-C, RBP4 and other risk factors The risk factors of carotid artery disease were 1.031, 1.685 and 1.049 respectively (95% CI, 1.005 ~ 1.058, 1.297 ~ 2.038 and 1.026 ~ 1.076, respectively). Conclusions RBP4 level is significantly associated with atherosclerosis, suggesting that RBP4 is one of the risk factors for carotid artery disease.
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