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目的探讨2型糖尿病患者糖耐量正常的一级亲属血浆sRAGE水平及其与各代谢性疾病危险因素之间的相关性。方法应用酶联免疫法测定51例2型糖尿病糖耐量正常一级亲属及48例正常对照者血浆sRAGE水平,测量腰围(WC)、臀围(WC)、体质量、收缩压(SBP)、舒张压(DBP),并检测甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS),计算腰臀比(WHR)、体质量指数[BMI=体质量(kg)/身高(m2)]和胰岛素抵抗指数[HOMA-IR=(FBG×FINS)/22.5]等相关指标,运用两样本t检验比较两组人群上述指标间的差异,运用Pearson相关分析和多元线性逐步回归分析观察组血浆sRAGE水平同SBP、DBP、WC、HC、BMI、TG、TC、HDL-C、LDL-C、HOMA-IR之间的关系,探索观察组人群特点。以BMI=25为切点,将观察组分为体质量指数正常组和超重肥胖组,并对血浆sRAGE水平进行比较,进一步验证BMI与sRAGE的关系。结果与对照组相比,观察组TG、FINS、HOMA-IR水平显著升高(P<0.05),HDL-C、sRAGE水平明显降低(P<0.05);血浆sRAGE水平与BMI、WC、HC、WHR、FBG呈明显负相关(P<0.05);BMI是血浆sRAGE的独立相关因素(复相关系数R2=0.145)。超重肥胖组的sRAGE水平明显低于体质量指数正常组(P<0.05)。结论 2型糖尿病患者糖耐量正常一级亲属血浆sRAGE水平较正常人群降低,BMI的升高是其下降的独立危险因素。
Objective To investigate the plasma sRAGE level in first-degree relatives with normal glucose tolerance and its correlation with risk factors of metabolic diseases in type 2 diabetic patients. Methods Serum levels of sRAGE were measured in 51 cases of type 2 diabetic patients with normal glucose tolerance and 48 normal controls by enzyme-linked immunosorbent assay. The changes of waist circumference (WC), hip circumference (WC), body mass, systolic blood pressure (SBP) (DBP) and triglyceride (TG), cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and fasting insulin (FINS) WHR, BMI = body mass (kg) / height (m2) and insulin resistance index (HOMA-IR = (FBG × FINS) /22.5) The plasma levels of sRAGE were the same as SBP, DBP, WC, HC, BMI, TG, TC, HDL-C, LDL-C and HOMA-IR in the observation group by Pearson correlation analysis and multivariate linear stepwise regression analysis Between the relationship between the group to explore the characteristics of observation group. Taking BMI = 25 as the cut-off point, the observation group was divided into the normal body mass index group and the overweight and obesity group, and the plasma sRAGE levels were compared to further verify the relationship between BMI and sRAGE. Results Compared with the control group, the levels of TG, FINS and HOMA-IR in the observation group were significantly increased (P <0.05) and the levels of HDL-C and sRAGE were significantly decreased (P <0.05) WHR and FBG (P <0.05). BMI was an independent factor of plasma sRAGE (R2 = 0.145). The level of sRAGE in overweight and obesity group was significantly lower than that in normal group (P <0.05). Conclusions Plasma sRAGE levels in normal glucose tolerance normal first-degree relatives of type 2 diabetic patients are lower than those in normal subjects. Elevated BMI is an independent risk factor for their decline.