CAJ | 학술논문

目的探讨血浆脂肪细胞型脂肪酸结合蛋白(A FABP)与老年2型糖尿病(T2DM)患者下肢血管病变程度的关系. 方法选择老年T2DM患者1 26例进行双下肢高分辨彩色多普勒检查,根据其下肢血管病变程度分为单纯T2DM组42例,合并轻度下肢动脉粥样硬化组(轻度硬化组)40例,合并重度下肢动脉粥样硬化组(重度硬化组)44例;并选择同期健康体检者40例为对照组.采用ELISA方法测定空腹血浆A-FABP水平,检测血糖、血脂、胰岛素抵抗指数(HOMR-IR)、超敏C反应蛋白(hs CRP)、肾小球滤过率等代谢指标. 结果血浆A-FABP水平比较,对照组(4.5±1.7)μg/L＜单纯T2DM组(6.1±2.1)μg/L＜轻度硬化组(7.2±2.3)μg/L＜重度硬化组(8.4±3.2)μg/L,差异有统计学意义(P＜0.01).而且随着踝肱指数的降低和下肢血管内膜中层厚度的升高,血浆A FABP也随之升高.多因素Logistic回归分析结果显示,血浆A-FABP水平是老年T2DM患者发生下肢血管病变的主要影响因素之一(P＜0.01).多元逐步回归分析显示,低密度脂蛋白、糖化血红蛋白、H()MR-IR、hs CRP是老年T2DM患者血浆A-FABP的独立预测因子. 结论血浆A-FABP与老年T2DM患者下肢血管病变程度相关,在老年T2DM患者下肢血管病变的发生中起重要作用.
목적 탐토혈장지방세포형지방산결합단백(A FABP)여노년2형당뇨병(T2DM)환자하지혈관병변정도적관계. 방법 선택노년T2DM환자1 26례진행쌍하지고분변채색다보륵검사,근거기하지혈관병변정도분위단순T2DM조42례,합병경도하지동맥죽양경화조(경도경화조)40례,합병중도하지동맥죽양경화조(중도경화조)44례;병선택동기건강체검자40례위대조조.채용ELISA방법측정공복혈장A-FABP수평,검측혈당、혈지、이도소저항지수(HOMR-IR)、초민C반응단백(hs CRP)、신소구려과솔등대사지표. 결과 혈장A-FABP수평비교,대조조(4.5±1.7)μg/L＜단순T2DM조(6.1±2.1)μg/L＜경도경화조(7.2±2.3)μg/L＜중도경화조(8.4±3.2)μg/L,차이유통계학의의(P＜0.01).이차수착과굉지수적강저화하지혈관내막중층후도적승고,혈장A FABP야수지승고.다인소Logistic회귀분석결과현시,혈장A-FABP수평시노년T2DM환자발생하지혈관병변적주요영향인소지일(P＜0.01).다원축보회귀분석현시,저밀도지단백、당화혈홍단백、H()MR-IR、hs CRP시노년T2DM환자혈장A-FABP적독립예측인자. 결론 혈장A-FABP여노년T2DM환자하지혈관병변정도상관,재노년T2DM환자하지혈관병변적발생중기중요작용.
Objective To explore the relationship between adipocyte fatty acid binding protein (A-FABP) and lower limb vascular disease (LLVD) in the elderly with type 2 diabetes(T2DM).Methods Bilateral lower limb vessels were checked by the High Resolution Color Doppler in all the subjects,including 40 healthy subjects as control (group A),126 T2DM patients.42 T2DM patients had no LLVD (group B),40 had mild LLVD (group C),and 44 had severe LLVD (group D).The levels of plasma A-FABP,blood glucose,lipid profiles,HOMA-IR,hypersensitive C reactive protein (hs CRP),and e-glomerular filtration rate were determined.Results The levels of plasma A-FABP were in the following ascending order of group A(4.5± 1.7)μg/L＜group B(6.1±2.1)μg/L＜group C (7.2 ± 2.3)μg/L ＜ group D (8.4 ± 3.2)μg/L (P＜ 0.01).A-FABP levels elevated along with the decrease of ABI and the increase of L IMT.Multiple logistic regression analysis showed that A FABP levels was main influencing factor of lower limb vascular disease (LLVD) in the elderly with type 2 diabetes.LDL C,HbA1c,HOMR-IR,hs-CRP were the predictive factors for the plasma A-FABP levels in the elderly with T2DM after multiple stepwise regression analysis.Conclusions For elder T2DM patients,the level of plasma A FABP is correlated with the degree of LLVD,and plays an important role in the progress of LLVD.