血清白细胞介素18、胱抑素C与2型糖尿病下肢血管病变的关系
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摘要
目的:探讨血清白细胞介素18(IL-18)和胱抑素C(CysC)与2型糖尿病(T2DM)及下肢血管病变的关系及临床价值。方法:选择112例住院的T2DM病人为A组,同期健康体检者30名为对照组(B组)。彩超测定下肢血管内膜厚度(IMT),A组分为3个亚组:A1亚组(IMT<1.0 mm),A2亚组(1.0 mm≤IMT<1.3 mm),A3亚组(IMT≥1.3 mm)。检测各组空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血脂、肌酐(Cr)、IL-18、CysC等相关指标。结果:A组血清IL-18、CysC水平均高于B组(P<0.01);各亚组的血清IL-18、CysC比较,A3亚组高于A1、A2亚组,A2亚组高于A1亚组(P<0.05);多因素多元线性回归结果显示,IL-18、CysC、TC、FPG与下肢IMT呈正相关。结论:血清IL-18、CysC是IMT的主要影响因素,血清IL-18、CysC与T2DM及下肢IMT存在相关性。
Objective:To investigate the relationhsips between the levels of interleukin 18(IL-18) and cystatin C(CysC),and lower extremity vascular lesions in type 2 diabetes mellitus(T2DM) patients,and its clinical significance.Methods:One hundred and twelve patients with T2DM and 30 healthy people were divided into the group A and group B,respectively.According to the arterial intima-media thickness(IMT) of lower extremity vascular detected by ultrasound,the group A was divided into the subgroup A1(IMT<1.0 mm),subgroup A2(1.0 mm≤IMT<1.3 mm) and subgroup A3(IMT≥1.3 mm).The levels of fasting blood glucose(FBG),glycosylated hemoglobin,blood lipid,creatinine,IL-18 and CysC were measured in all groups.Results:The levels of serum IL-18 and CysC in group A were higher than those in group B(P<0.01).The serum levels of IL-18 and CysC in A3 and A2 subgroups were higher than those in A1 and A2 subgroups,and subgroup A1,respectively(P<0.05).Multivariate linear regression analysis showed that the levels of IL-18,CysC,total cholesterol and FBG were positively correlated with the IMT of lower extremity vascular.Conclusions:The serum levels of IL-18 and CysC are the main influencing factors of IMT,and correlated with the T2DM and IMT of lower limb artery.
Objective:To investigate the relationhsips between the levels of interleukin 18(IL-18) and cystatin C(CysC),and lower extremity vascular lesions in type 2 diabetes mellitus(T2DM) patients,and its clinical significance.Methods:One hundred and twelve patients with T2DM and 30 healthy people were divided into the group A and group B,respectively.According to the arterial intima-media thickness(IMT) of lower extremity vascular detected by ultrasound,the group A was divided into the subgroup A1(IMT<1.0 mm),subgroup A2(1.0 mm≤IMT<1.3 mm) and subgroup A3(IMT≥1.3 mm).The levels of fasting blood glucose(FBG),glycosylated hemoglobin,blood lipid,creatinine,IL-18 and CysC were measured in all groups.Results:The levels of serum IL-18 and CysC in group A were higher than those in group B(P<0.01).The serum levels of IL-18 and CysC in A3 and A2 subgroups were higher than those in A1 and A2 subgroups,and subgroup A1,respectively(P<0.05).Multivariate linear regression analysis showed that the levels of IL-18,CysC,total cholesterol and FBG were positively correlated with the IMT of lower extremity vascular.Conclusions:The serum levels of IL-18 and CysC are the main influencing factors of IMT,and correlated with the T2DM and IMT of lower limb artery.
引文
[1] 白耀波.血清胱抑素C(CsyC)与2型糖尿病下肢血管病变的关系分析[J].中国医药指南,2016,14(27):77.
[2] 安祥博,张幼怡,宋峣.运动对炎症反应的抑制作用[J].中国心血管杂志,2016,6:432.
[3] KASAMI R,KANETO H,KATAKAMI N,et al.Relationship between carotid inti-ma-media thickness and the presence and extent of coronary stenosis in type 2 disease[J].Diabetes Care,2011,34(2):468.
[4] 何文.颈动脉超声与临床[J].中国卒中杂志,2009(7):547.
[5] STEIN JH,KORCARZ CE,HURST RT,et al.Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk:a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force[J].J Am Soc Echocardiog,2008,21(2):93.
[6] 于静宁.不同部位动脉内膜中层厚度与 2 型糖尿病合并不同临床大血管疾病的相关性研究[D].大连:大连医科大学,2015.
[7] NICOLETTI F,DI MARCO R,PAPACCIO G,et al.Essential pathogenic role of endogenous IL-18 in murine diabetes induced by multiple low doses of streptozotocin.Prevention of hyperglycemia and insulitis by a recombinant IL-18-binding protein:Fc construct[J].Eur J Immunol,2003,33(8):2278.
[8] 丁法明,王聪霞,张春艳,等.基质金属蛋白酶-9和白介素-18在冠心病及糖尿病大血管并发症中的作用[J].西安交通大学学报(医学版),2014,35(5):646.
[9] 牛亚妹.急性脑梗死患者血清中hs-CRP、TNF-α、IL-6水平与颈动脉硬化斑块的关系[J/CD].世界最新医学信息文摘(电子版),2016,16(102):62.
[10] 李秀芹,卜培莉.血浆网膜素-1、白介素-18和白介素-16水平与冠心病关系的研究[J].山东大学学报(医学版),2012,50(10):86.
[11] 许涛,刘和俊,周碧蓉.颈动脉 IMT、IL-18、MMP-9 及 Fib 与急性冠脉综合征合并 2 型糖尿病的相关性研究[J].安徽医科大学学报,2015,50(12):1785.
[12] SALGADO JV,SOUZA FL,SALGADO BJ.How to understand the association between cystatin C levels and cardiovascular disease:Imbalance,counterbalance,or consequence?[J].J Cardiol,2013,62 (6):331.
[13] 王霞,何訸,周君,等.糖尿病前期患者血尿酸水平与餐后2 h血糖水平相关性分析[J].四川大学学报(医学版),2015,46(5):750.
[14] 李靖娴.2型糖尿病患者胱抑素C与胰岛素抵抗及目细胞功能的相关性研究[D].济南:山东大学,2015.
[15] 姜镇,栗印军.胱抑素 C 与冠状动脉粥样硬化类疾病的相关性研究进展[J].中国医师进修杂志,2014,2(37):177.
[16] SUKHOVA GK,WANG B,LIBBY P,et al.Cystatin C deficiency increasesel asticlamina degradatio nandaortic dilatation in apolipoprote in E-null mice[J].Circ Res,2005,96(3):368.
[17] 曾昭梅,邓海燕.血清胱抑素c、25-羟维生素D水平与糖尿病患者颈动脉内膜中层厚度的相关性[J].中外医学研究,2017,15(18):4.
[18] 张弓.新发2型糖尿病患者下肢动脉硬化与胱抑素c水平的相关性分析[J].广州医科大学学报,2016,44(1):23.
[2] 安祥博,张幼怡,宋峣.运动对炎症反应的抑制作用[J].中国心血管杂志,2016,6:432.
[3] KASAMI R,KANETO H,KATAKAMI N,et al.Relationship between carotid inti-ma-media thickness and the presence and extent of coronary stenosis in type 2 disease[J].Diabetes Care,2011,34(2):468.
[4] 何文.颈动脉超声与临床[J].中国卒中杂志,2009(7):547.
[5] STEIN JH,KORCARZ CE,HURST RT,et al.Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk:a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force[J].J Am Soc Echocardiog,2008,21(2):93.
[6] 于静宁.不同部位动脉内膜中层厚度与 2 型糖尿病合并不同临床大血管疾病的相关性研究[D].大连:大连医科大学,2015.
[7] NICOLETTI F,DI MARCO R,PAPACCIO G,et al.Essential pathogenic role of endogenous IL-18 in murine diabetes induced by multiple low doses of streptozotocin.Prevention of hyperglycemia and insulitis by a recombinant IL-18-binding protein:Fc construct[J].Eur J Immunol,2003,33(8):2278.
[8] 丁法明,王聪霞,张春艳,等.基质金属蛋白酶-9和白介素-18在冠心病及糖尿病大血管并发症中的作用[J].西安交通大学学报(医学版),2014,35(5):646.
[9] 牛亚妹.急性脑梗死患者血清中hs-CRP、TNF-α、IL-6水平与颈动脉硬化斑块的关系[J/CD].世界最新医学信息文摘(电子版),2016,16(102):62.
[10] 李秀芹,卜培莉.血浆网膜素-1、白介素-18和白介素-16水平与冠心病关系的研究[J].山东大学学报(医学版),2012,50(10):86.
[11] 许涛,刘和俊,周碧蓉.颈动脉 IMT、IL-18、MMP-9 及 Fib 与急性冠脉综合征合并 2 型糖尿病的相关性研究[J].安徽医科大学学报,2015,50(12):1785.
[12] SALGADO JV,SOUZA FL,SALGADO BJ.How to understand the association between cystatin C levels and cardiovascular disease:Imbalance,counterbalance,or consequence?[J].J Cardiol,2013,62 (6):331.
[13] 王霞,何訸,周君,等.糖尿病前期患者血尿酸水平与餐后2 h血糖水平相关性分析[J].四川大学学报(医学版),2015,46(5):750.
[14] 李靖娴.2型糖尿病患者胱抑素C与胰岛素抵抗及目细胞功能的相关性研究[D].济南:山东大学,2015.
[15] 姜镇,栗印军.胱抑素 C 与冠状动脉粥样硬化类疾病的相关性研究进展[J].中国医师进修杂志,2014,2(37):177.
[16] SUKHOVA GK,WANG B,LIBBY P,et al.Cystatin C deficiency increasesel asticlamina degradatio nandaortic dilatation in apolipoprote in E-null mice[J].Circ Res,2005,96(3):368.
[17] 曾昭梅,邓海燕.血清胱抑素c、25-羟维生素D水平与糖尿病患者颈动脉内膜中层厚度的相关性[J].中外医学研究,2017,15(18):4.
[18] 张弓.新发2型糖尿病患者下肢动脉硬化与胱抑素c水平的相关性分析[J].广州医科大学学报,2016,44(1):23.