βn 2GPI/oxLDL复合物在2型糖尿病合并脑梗死患者中检测的临床意义n

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目的:探讨βn 2糖蛋白I/氧化性低密度脂蛋白(βn 2 glycoprotein I/oxidized low density lipoprotein,βn 2GPI/oxLDL)复合物在2型糖尿病(type 2 diabetes mellitus,T2DM)合并脑梗死患者中检测的临床意义。n 方法:选取2014年6月至2015年12月哈尔滨医科大学附属第二医院就诊的患者分为无脑梗死T2DM组(82例) 、T2DM合并脑梗死组(79例)、脑梗死组(80例),同时选取同期体检者作为对照组(78例)。采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测βn 2GPI/oxLDL复合物的含量。Spearman分析各组中空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-h Postprandial blood glucose,2hPG)、糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、空腹胰岛素(fasting insulin,FINS)、总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平与βn 2GPI/oxLDL复合物水平是否相关。单因素和多元Logistic回归分析所选变量的相对危险度。n 结果:T2DM合并脑梗死组血清βn 2GPI/oxLDL复合物水平[(1.09±0.16)U/mL]与无脑梗死T2DM组[(0.95±0.13)U/mL]和对照组[(0.81±0.12)U/mL]相比,其水平显著升高(n P值均<0.05)。在T2DM合并脑梗死患者中,βn 2GPI/oxLDL水平与TG呈正相关(n r= 0.39,n P=0.04)。单因素分析显示,升高的βn 2GPI/oxLDL明显与T2DM合并脑梗死组[n OR=2.48,95%n CI:(1.72~3.03),n P=0.001]或是无脑梗死T2DM组[n OR=1.61,95%n CI:(1.11~3.77),n P=0.004]存在关联。在多变量分析中,在校正了年龄、性别、血脂水平后,βn 2GPI/oxLDL与T2DM合并脑梗死的存在呈现独立相关[n OR=3.11,95%n CI:(2.01~5.32),n P=0.033]。n 结论:βn 2GPI/oxLDL水平在T2DM患者中增加,以T2DM合并脑梗死的患者中增加显著。βn 2GPI/oxLDL的升高与T2DM合并脑梗死的发生呈独立相关。n “,”Objective:Study of clinical significance about β n 2 glycoprotein I/oxidized low density lipoprotein(βn 2GPI/oxLDL)complexes in type 2 diabetes mellitus(T2DM)combined with cerebral infarction.n Methods:The patients were enrolled as the research object admitted to the second affiliated hospital of Harbin medical university from June 2014 to December 2015.Including 82 cases in non cerebral infarction T2DM group, 79 cases in T2DM combined with cerebral infarction group and 80 cases in cerebral infarction group.At the same time, 78 cases with concurrent physical examination were selected as the control group.βn 2GPI/oxLDL was measured using enzyme-linked immunosorbent assay(ELISA). Spearman method was applied in the each group to prove whether the indexes of fasting blood glucose(FBG), 2-h Postprandial blood glucose(2hPG), glycosylated hemoglobin A1c(HbA1c), fasting insulin(FINS), total cholesterol(TC), triglycerides(TG), high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)were related with the levels of the β n 2GPI/oxLDL complex.Univariate and multivariate logistic regression analyses were used to analyze the relative risks for selected variables.n Results:Serum β n 2GPI/oxLDL complex levels were significantly elevated in T2DM with (1.09±0.16) U/mL and without(0.95±0.13) U/mL cerebral infarction compared with healthy controls (0.81±0.12) U/mL.In T2DM with cerebral infarction, the β n 2GPI/oxLDL levels were positively correlated with TG(n r=0.39, n P=0.04). The univariate analyses revealed that increased β n 2GPI/oxLDL levels were significantly associated with the presence of T2DM with cerebral infarction[n OR=2.48, 95%n CI: (1.72~3.03), n P=0.001] or without cerebral infarction[n OR=1.61, 95% n CI: (1.11~3.77), n P=0.004]. In the multivariate analysis, after adjusting for age, gender, and serum lipid levels, β n 2GPI/oxLDL was independently associated with the presence of cerebral infarction.[n OR=3.11, 95% n CI: (2.01~5.32), n P=0.033].n Conclusions:Serum β n 2GPI/oxLDL levels were increased in patients with T2DM, especially in those with cerebral infarction.Elevated β n 2GPI/oxLDL complex levels might be associated with the presence of diabetic cerebral infarction complications.n
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