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目的探讨视黄醇结合蛋白4及血管内皮功能在2型糖尿病(T2DM)合并代谢综合(MS)征发生、发展中的作用机制。方法将2型糖尿病患者117例根据有无合并代谢综合征分为2型糖尿病合并代谢综合征组(67例)和2型糖尿病不合并代谢综合征组(50例),另设对照组37例。比较各组的一般情况、血脂、糖代谢等生化指标和黄醇结合蛋白4、可溶性血管细胞粘附分子-1的差异。结果 (1)2型糖尿病合并代谢综合征组的血清黄醇结合蛋白4水平明显高于2型糖尿病不合并代谢综合征组组(P<0.01),且两组黄醇结合蛋白4水平均高于对照组(P<0.01);(2)2型糖尿病合并代谢综合征组的血清可溶性血管细胞粘附分子-1水平明显高于2型糖尿病不合并代谢综合征组(P<0.01),且两组可溶性血管细胞粘附分子-1水平均高于对照组(P均<0.01);(3)相关分析显示,血清黄醇结合蛋白4与可溶性血管细胞粘附分子-1、体重指数、腰围、空腹血糖、收缩压、甘油三酯、总胆固醇、低密度脂蛋白胆固醇显著正相关(P<0.01或P<0.05),与高密度脂蛋白胆固醇显著负相关(P<0.05)。结论黄醇结合蛋白4与血管内皮功能障碍可能参与了2型糖尿病合并代谢综合征的发生与发展。
Objective To investigate the mechanism of action of retinol binding protein 4 and vascular endothelial function in the pathogenesis of type 2 diabetes mellitus (T2DM) complicated by metabolic syndrome (MS). Methods According to the presence or absence of metabolic syndrome, 117 patients with type 2 diabetes mellitus were divided into type 2 diabetes mellitus with metabolic syndrome (67 cases) and type 2 diabetes mellitus without metabolic syndrome (50 cases). Another 37 patients . Compare the general situation of each group, the biochemical indexes such as blood lipid and glucose metabolism, and the difference of flavonol binding protein 4 and soluble vascular cell adhesion molecule-1. Results (1) Serum alcohol-binding protein 4 level in type 2 diabetes mellitus with metabolic syndrome was significantly higher than that in type 2 diabetes mellitus without metabolic syndrome (P <0.01), and both alcohol-binding protein 4 levels were high (P <0.01). (2) The level of serum soluble vascular cell adhesion molecule-1 in type 2 diabetic patients with metabolic syndrome was significantly higher than that in type 2 diabetic patients without metabolic syndrome (P <0.01), and The levels of soluble vascular cell adhesion molecule-1 in the two groups were significantly higher than those in the control group (all P <0.01). (3) The correlation analysis showed that the serum levels of Flavoprotein 4 and soluble vascular cell adhesion molecule-1, body mass index , Fasting blood glucose, systolic blood pressure, triglyceride, total cholesterol, low density lipoprotein cholesterol (P <0.01 or P <0.05), and negatively correlated with high density lipoprotein cholesterol (P <0.05). Conclusions Flavoprotein 4 and vascular endothelial dysfunction may be involved in the occurrence and development of type 2 diabetes with metabolic syndrome.