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目的探讨血清P-选择素、瘦素及相关代谢指标与2型糖尿病(type 2diabetes mellitus,T2DM)及大血管病变(macrovascular lesion,MVL)的关系。方法 T2DM患者300例,依据是否合并MVL分为MVL组和非MVL组各150例,选择同期体检健康者100例为对照组。检测并比较各组空腹血清P-选择素、瘦素水平等指标,分析P-选择素、瘦素与T2DM及MVL的关系。结果 MVL组及非MVL组血清瘦素水平[(1.61±1.07)、(1.32±1.10)μg/L]、P-选择素水平[(5.40±4.10)、(3.10±2.10)μg/L]均高于对照组[(1.14±1.04)、(1.40±0.40)μg/L],MVL组高于非MVL组,差异有统计学意义(P<0.05);T2DM组血清P-选择素与瘦素(r=0.361,P=0.050)、体质量指数(r=0.360,P=0.050)、三酰甘油(r=0.370,P=0.044)、低密度脂蛋白胆固醇(r=0.407,P=0.026)呈正相关,与空腹血糖(r=-0.396,P=0.036)、空腹胰岛素(r=-0.376,P=0.041)呈负相关,与年龄、高密度脂蛋白胆固醇、总胆固醇无明显相关性(P>0.05);血清瘦素水平与T2DM合并MVL相关。结论血清P-选择素、瘦素与肥胖、糖脂代谢紊乱、胰岛素抵抗密切相关,瘦素水平升高是T2DM患者MVL的危险因素。
Objective To investigate the relationship between serum P-selectin, leptin and related metabolic markers and type 2 diabetes mellitus (T2DM) and macrovascular lesion (MVL). Methods 300 patients with T2DM were divided into MVL group and non-MVL group according to whether they were combined with MVL, and 100 healthy subjects were selected as the control group. The fasting serum levels of P-selectin and leptin were detected and compared. The relationship between P-selectin, leptin and T2DM and MVL was analyzed. Results The levels of serum leptin in MVL group and non-MVL group were significantly higher than those in MVL group [(1.61 ± 1.07), (1.32 ± 1.10) μg / L], P-selectin level [(5.40 ± 4.10), (3.10 ± 2.10) μg / L] (1.14 ± 1.04) and (1.40 ± 0.40) μg / L, respectively, which were significantly higher in MVL group than those in non-MVL group (P <0.05) body mass index (r = 0.360, P = 0.050), triglyceride (r = 0.370, P = 0.044), LDL cholesterol (r = 0.407, P = 0.026) (R = -0.396, P = 0.036), fasting insulin (r = -0.376, P = 0.041), but no significant correlation with age, HDL cholesterol and total cholesterol > 0.05). Serum leptin level correlated with T2DM with MVL. Conclusion Serum P-selectin, leptin and obesity, glucose and lipid metabolism disorders, insulin resistance are closely related to leptin levels in T2DM patients with MVL risk factors.