【摘要】：目的:探討血清護骨素(osteoprotegerin,OPG)水平與老年2型糖尿病患者頸動脈粥樣硬化發(fā)生、發(fā)展的關(guān)系。OPG是否為老年2型糖尿病患者頸動脈IMT增厚、狹窄發(fā)生的獨立危險因素。方法:選取山西醫(yī)科大學第二臨床醫(yī)院就診的老年2型糖尿病患者143例,用彩色多普勒超聲檢查結(jié)果將受試者根據(jù)頸動脈內(nèi)膜中層厚度(IMT)水平分為IMT正常組36例,IMT增厚組107例;又根據(jù)頸動脈是否有狹窄分為頸動脈無狹窄組109例,頸動脈狹窄組34例。所有受試者統(tǒng)一測定各項生化指標(包括空腹血糖、糖化血紅蛋白、甘油三酯、總膽固醇、高密度脂蛋白、低密度脂蛋白及尿酸),血清OPG水平用酶聯(lián)免疫吸附實驗(ELISA)統(tǒng)一檢測。結(jié)果:IMT增厚組年齡、糖尿病病程、SBP、DBP、空腹血糖、糖化血紅蛋白、尿酸及血清OPG明顯高于IMT正常組。頸動脈狹窄組年齡、糖尿病病程、高血壓病史、空腹血糖、糖化血紅蛋白、尿酸及血清OPG明顯高于頸動脈無狹窄組。IMT增厚組與IMT正常組在年齡、尿酸及血清OPG水平比較差異有統(tǒng)計學意義(P㩳0.05),頸動脈狹窄組與頸動脈無狹窄組血清OPG水平、尿酸比較差異有統(tǒng)計學意義(P㩳0.05)。老年2型糖尿病患者頸動脈IMT增厚組血清OPG水平與血總膽固醇(r=0.196,P=0.044)、低密度脂蛋白(r=0.213,P=0.028)呈正相關(guān),與糖尿病病程(r=-0.320,P=0.001)負相關(guān);老年2型糖尿病患者頸動脈狹窄組血清OPG水平與糖化血紅蛋白水平(r=0.366,P=0.033)、空腹血糖(r=0.362,P=0.35)呈正相關(guān)。logistic回歸分析顯示,OPG、尿酸為頸動脈狹窄發(fā)生的危險因素(OR=1.011,95%CI:1.006-1.016,P=0.000),(OR=1.010,95%CI:1.004-1.016,P=0.002)。結(jié)論:老年2型糖尿病患者,OPG升高與頸動脈粥樣硬化密切相關(guān),是頸動脈粥樣硬化發(fā)生的危險因素。
[Abstract]:Objective: to investigate the relationship between serum osteoprotegerin (osteoprotegerin,OPG) level and carotid atherosclerosis in elderly patients with type 2 diabetes mellitus. Methods: 143 elderly patients with type 2 diabetes mellitus were selected from the second Clinical Hospital of Shanxi Medical University. According to the (IMT) level of carotid intima-media thickness, the subjects were divided into 36 cases of normal IMT group and 107 cases of IMT-thickening group. According to the carotid artery stenosis, 109 cases were divided into carotid artery stenosis group (109 cases) and carotid artery stenosis group (34 cases). The biochemical indexes (including fasting blood glucose, glycosylated hemoglobin, triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein and uric acid) and serum OPG were determined by enzyme linked immunosorbent assay (ELISA). Results the age, duration of diabetes, fasting blood glucose, glycosylated hemoglobin, uric acid and serum OPG were significantly higher in the thickening group than those in the normal IMT group. Age, course of diabetes, history of hypertension, fasting blood glucose, glycosylated hemoglobin, uric acid and serum OPG in carotid artery stenosis group were significantly higher than those in carotid artery stenosis group and normal IMT group. The levels of uric acid and serum OPG were significantly different (P0. 05). The levels of serum OPG and uric acid were significantly different between carotid stenosis group and no carotid artery stenosis group (P0. 05). In elderly patients with type 2 diabetes mellitus, the level of serum OPG in carotid IMT thickening group was positively correlated with serum total cholesterol (r = 0.196 P0. 044), low density lipoprotein (r = 0.213), and negatively correlated with the course of diabetes (r = -0.320, P0. 001). The levels of serum OPG and glycosylated hemoglobin (RHG) were positively correlated with glycosylated hemoglobin (RHG) and fasting blood glucose (RG0.362P0. 35) in elderly type 2 diabetic patients with carotid artery stenosis. Logistic regression analysis showed that serum OPG and uric acid were risk factors of carotid artery stenosis (OR=1.011,95%CI:1.006-1.016,P=0.000), (OR=1.010,95%CI:1.004-1.016,P=0.002). Conclusion: the increase of OPG in elderly patients with type 2 diabetes is closely related to carotid atherosclerosis and is a risk factor for carotid atherosclerosis.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R587.2

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