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目的:探讨血清生长分化因子(GDF)-15与2型糖尿病(T2DM)及T2DM合并大血管病变的关系。方法:选择60例初发T2DM患者,根据是否合并大血管病变分为A组(单纯T2DM)30例,B组(T2DM合并大血管病变)30例,另选择30例体检健康老年人作为正常对照(C组);记录年龄、身高、体重,测量血压、腰围、臀围,计算体制指数(BMI)、臀腰比(WHR),检测血清GDF-15、血脂、糖化血红蛋白(HbA1c)及超敏C反应蛋白(hsCRP)水平;对检测结果进行统计学处理,分析其影响因素。结果:A组及B组血清GDF-15水平均高于C组;B组血清GDF-15水平高于A组;GDF-15水平与WHR、SBP、TC、TG、LDL、HbA1c、hsCRP呈正相关,与HDL呈负相关;多元线性逐步回归分析显示hsCRP、LDL是影响血清GDF-15水平的主要因素。结论:血清GDF-15在T2DM及T2DM合并大血管病变中均升高,且在T2DM合并大血管病变中升高更为明显。GDF-15可能通过脂质代谢和炎症反应等多个环节参与2型糖尿病及其大血管病变的发生发展。
Objective: To investigate the relationship between serum growth factor (GDF) -15 and type 2 diabetes mellitus (T2DM) and T2DM with macrovascular complications. Methods: Sixty patients with newly diagnosed T2DM were enrolled. Thirty patients in group A (T2DM alone) and 30 patients in group B (T2DM with macrovascular disease) were selected according to whether they had complicated macrovascular complications. Thirty healthy controls were selected as healthy controls (Group C) .Blood pressure, waist circumference, hip circumference, BMI, WHR, serum GDF-15, HbA1c and hypersensitivity C-reactive protein (hsCRP) levels; the test results were statistically analyzed, analysis of its influencing factors. Results: Serum levels of GDF-15 in group A and group B were significantly higher than those in group C; serum GDF-15 levels in group B were higher than those in group A; GDF-15 levels were positively correlated with WHR, SBP, TC, TG, LDL, HbA1c and hsCRP , And was negatively correlated with HDL. Multiple linear stepwise regression analysis showed that hsCRP and LDL were the main factors affecting serum GDF-15 levels. CONCLUSION: Serum GDF-15 is elevated in both T2DM and T2DM with macrovascular complications and is more pronounced in T2DM with macrovascular complications. GDF-15 may participate in the development of type 2 diabetes and its macroangiopathy through multiple links such as lipid metabolism and inflammatory response.