论文部分内容阅读
目的观察二甲双胍对T2DM患者血清前蛋白转化酶枯草溶菌素9(PCSK9)水平的影响。方法选取93例新诊断的T2DM患者,随机分为二甲双胍治疗组(Met组,n=47)和格列吡嗪治疗组(Gli组,n=46)。同时另选择48名健康人作为对照组(NGT组)。采用ELISA测定T2DM患者及健康人群PCSK9水平。观察治疗前后T2DM患者血清PCSK9水平变化。结果与NGT组比较,治疗前Met组、Gli组血清PCSK9水平升高[(3.93±0.71)vs(5.42±1.03)、(5.78±1.61)ng/ml,P<0.01];相关性分析显示,血清CKSP9水平与FPG、HbA_1c、胰岛素抵抗指数(HOMA-IR)、FIns、TC、LDL-C、TG、高敏C-反应蛋白(hsC-RP)、TNF-α、BMI呈正相关(r=0.578、0.638、0.556、0.610、0.578、0.592、0.589、0.638、0.561、0.552,P<0.05或P<0.01),与HDL-C呈负相关(r=-0.614,P<0.01);治疗后Met组PCSK9水平下降(P<0.05);治疗后Gli组血清PCSK9水平无明显变化(P>0.05)。多元线性回归分析显示,TNF-α、HOMA-IR是PCSK9的独立影响因素。结论T2DM患者血清PCSK9水平增高,二甲双胍可降低T2DM患者血清PCSK9的水平。
Objective To observe the effect of metformin on the serum preprotein convertase subtilisin 9 (PCSK9) in patients with T2DM. Methods Ninety-three newly diagnosed T2DM patients were randomly divided into metformin treatment group (Met group, n = 47) and glipizide treatment group (Gli group, n = 46). At the same time, another 48 healthy people were selected as the control group (NGT group). The level of PCSK9 in T2DM patients and healthy subjects was measured by ELISA. Changes of serum PCSK9 level in T2DM patients before and after treatment were observed. Results Compared with NGT group, the levels of serum PCSK9 in Met group and Gli group before treatment were significantly higher than that of NGT group [(3.93 ± 0.71) vs (5.42 ± 1.03), (5.78 ± 1.61) ng / ml, P <0.01] The level of serum CKSP9 was positively correlated with FPG, HbA 1c, HOMA-IR, FIns, TC, LDL-C, TG, hsC-RP and TNF- 0.638,0.556,0.610,0.578,0.592,0.589,0.638,0.561,0.552, P <0.05 or P <0.01), but negatively correlated with HDL-C (r = -0.614, P <0.01) (P <0.05). Serum PCSK9 level in Gli group did not change significantly after treatment (P> 0.05). Multivariate linear regression analysis showed that TNF-α and HOMA-IR were independent factors of PCSK9. Conclusion The serum level of PCSK9 in patients with T2DM is increased, and metformin can reduce the level of serum PCSK9 in patients with T2DM.