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目的:探讨2型糖尿病(T2DM)患者尿8-羟基脱氧鸟苷(8-OHdG)水平与下肢血管病变(LVD)的相关性。方法:选择T2DM患者194例,按照是否存在LVD分为T2DM组112例,T2DM+LVD组82例,同时选择健康体检者60人作为对照组,比较3组体质量指数(BMI)、腰臀比(WHR)、血压、空腹血糖(FBG)、血脂、胰岛素抵抗指数(HOMA-IR)和尿8-OHdG水平,并比较T2DM+LVD组不同病情患者HOMA-IR、尿8-OHdG水平,分析尿8-OHdG水平与LVD病情程度、HOMA-IR相关性。结果:3组糖化血红蛋白(Hb A1C)、低密度脂蛋白胆固醇(LDL-C)、HOMA-IR、尿8-OHdG间差异有统计学意义(P<0.05,P<0.01),随着病情的加重,上述指标明显升高,组间两两比较差异均有统计学意义(P<0.01);T2DM+LVD组轻度、中度、重度患者HOMA-IR、尿8-OHdG差异有统计学意义(P<0.01),随着病情的加重HOMA-IR、尿8-OHdG水平逐渐升高;经Pearson相关分析,T2DM合并LVD患者尿8-OHdG水平与HOMA-IR及LVD病变程度均呈显著正相关(r=0.412、0.538,均P<0.05),尿8-OHdG、HOMA-IR是T2DM患者发生LVD的独立危险因素。结论:尿8-OHdG水平可作为T2DM合并LVD的预测因子和病情判断的有效指标,在T2DM患者LVD的预防中应重视早期尿8-OHdG水平检测。
Objective: To investigate the relationship between urinary 8-OHdG (8-OHdG) level and lower extremity vascular disease (LVD) in type 2 diabetes mellitus (T2DM). Methods: A total of 194 patients with T2DM were selected. According to the presence or absence of LVD, there were 112 T2DM patients, 82 T2DM + LVD patients and 60 healthy volunteers as control group. The body mass index (BMI), waist-hip ratio (WHR), blood pressure, fasting blood glucose (FBG), lipids, insulin resistance index (HOMA-IR) and urinary 8-OHdG levels were measured. HOMA-IR and urine 8-OHdG were measured in patients with T2DM + 8-OHdG levels and LVD severity, HOMA-IR correlation. Results: The differences of Hb A1C, LDL-C, HOMA-IR and urine 8-OHdG were statistically significant (P <0.05, P <0.01) (P0.01) .HOMA-IR and urine 8-OHdG in mild, moderate and severe T2DM + LVD patients were significantly higher than those in T2DM + LVD patients (P <0.01). The level of urinary 8-OHdG increased with the increase of HOMA-IR. The Pearson correlation analysis showed that the urinary 8-OHdG level and the severity of HOMA-IR and LVD in T2DM with LVD were significantly positive (R = 0.412, 0.538, all P <0.05). Urine 8-OHdG and HOMA-IR were independent risk factors of LVD in T2DM patients. Conclusion: Urine 8-OHdG level can be used as a predictor of T2DM combined with LVD and a good indicator of disease severity. Early detection of urinary 8-OHdG level should be emphasized in the prevention of LVD in T2DM patients.