【摘要】：目的:探究血清胎盤生長(zhǎng)因子(plasma placental growth factor,PLGF)與2型糖尿病及相關(guān)大血管并發(fā)癥之間的關(guān)系,通過分析PLGF與炎癥反應(yīng)、糖脂代謝的相關(guān)性,探討PLGF作為2型糖尿病大血管并發(fā)癥早期預(yù)測(cè)因子,以及作為治療靶點(diǎn)的可能性。方法:根據(jù)有無2型糖尿病大血管并發(fā)癥,將58例2型糖尿病患者分為單純2型糖尿病組(T2DM組28例)和2型糖尿病合并大血管并發(fā)癥組(T2DM+MVC組30例)。根據(jù)大血管病變的入選標(biāo)準(zhǔn),選取相同時(shí)間于我院心內(nèi)科和神經(jīng)內(nèi)科住院治療的單純動(dòng)脈粥樣硬化患者30例(MVC組)。正常對(duì)照組(NGT組24例)來自相同時(shí)間于我院健康查體者。對(duì)所有研究對(duì)象的既往史和近期用藥史進(jìn)行問診,同時(shí)測(cè)量其身高、體重、計(jì)算體重指數(shù)BMI,檢測(cè)其空腹血糖(FPG)、超敏C反應(yīng)蛋白(hs-CRP)、血清甘油三酯(TG)、血清總膽固醇(TC)、血清高密度脂蛋白膽固醇(HDL-C)、血清低密度脂蛋白膽固醇(LDL-C)、糖化血紅蛋白(Hb A1c)、空腹C肽。對(duì)全部研究對(duì)象另單獨(dú)留取一份血清標(biāo)本,應(yīng)用ELISA法檢測(cè)其血清PLGF水平。結(jié)果:(1)T2DM、MVC、T2DM+MVC組血清PLGF水平(13.99±6.62,17.67±7.44,41.37±8.65)pg/ml均高于NGT組(9.67±6.59)pg/ml(P0.01),T2DM+MVC組血清PLGF水平又明顯高于T2DM組和MVC組(P0.01),T2DM與MVC組血清PLGF水平差異無統(tǒng)計(jì)學(xué)意義(P=0.06)。(2)四組血清PLGF水平與FPG、TC、TG、Hb A1c、hs-CRP呈正相關(guān)(r分別為0.486、0.300、0.217、0.427、0.519,P0.05);2型糖尿病患者血清PLGF水平與hs-CRP、TC、LDL-C呈正相關(guān)(r分別為0.444、0.390、0.278,P0.05),與空腹C肽呈負(fù)相關(guān)(r=-0.332,P0.05);動(dòng)脈粥樣硬化患者血清PLGF水平與FPG、Hb A1c、hs-CRP呈正相關(guān)(r分別為0.661、0.625、0.352,P0.05)。(3)Logistic回歸分析提示,PLGF、LDL-C、hs-CRP是動(dòng)脈粥樣硬化的危險(xiǎn)因素,HDL-C是動(dòng)脈粥樣硬化的保護(hù)因素。結(jié)論:(1)在單純2型糖尿病患者及單純動(dòng)脈粥樣硬化患者,血清PLGF水平較正常人升高,而2型糖尿病并發(fā)大血管并發(fā)癥的患者其血清PLGF水平進(jìn)一步升高,結(jié)合血清PLGF水平與hs-CRP呈正相關(guān),表明在2型糖尿病及動(dòng)脈粥樣硬化發(fā)病過程中,PLGF可能通過參與炎癥反應(yīng)促進(jìn)糖尿病及其大血管并發(fā)癥的發(fā)生、發(fā)展。因此,PLGF可能成為2型糖尿病大血管并發(fā)癥的一個(gè)早期預(yù)測(cè)指標(biāo),同時(shí)也為早期干預(yù)提供一個(gè)新的可能的切入點(diǎn)。(2)PLGF與空腹血糖、多種血脂成分、hs-CRP呈正相關(guān),因此通過降糖、調(diào)脂、控制體重等方法,可能使血清PLGF水平降低,從而延緩糖尿病及其大血管并發(fā)癥的發(fā)生、發(fā)展,減少威脅生命的心腦血管事件的發(fā)生。
[Abstract]:Objective: to investigate the relationship between serum placental growth factor (plasma placental growth factor,PLGF) and type 2 diabetes mellitus and related macrovascular complications, and to analyze the relationship between PLGF and inflammation, glucose and lipid metabolism. To explore the possibility of PLGF as an early predictor of macrovascular complications in type 2 diabetes mellitus and as a therapeutic target. Methods: according to the macrovascular complications of type 2 diabetes mellitus, 58 patients with type 2 diabetes mellitus were divided into two groups: type 2 diabetes mellitus group (T2DM group, 28 cases) and type 2 diabetes mellitus complicated with macrovascular complication group (T2DM MVC group, 30 cases). According to the selected criteria of macroangiopathy, 30 patients with simple atherosclerosis (MVC group) who were hospitalized in our department of cardiology and neurology at the same time were selected. Normal control group (NGT group 24 cases) from the same time in our hospital health check-up. At the same time, height and weight were measured, fasting blood glucose (FPG), hypersensitive C-reactive protein (hs-CRP) and serum triglyceride (TG),) were measured by body mass index (BMI,). Serum total cholesterol (TC), serum high density lipoprotein cholesterol (HDL-C), serum low density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (Hb A1c), fasting C peptide. A single serum sample was collected from all subjects, and the serum PLGF level was measured by ELISA method. Results: (1) the serum PLGF level in T2DM, MVC, T2DM MVC group (13.99 鹵6.62, 17.67 鹵7.44, 41.37 鹵8.65) pg/ml was higher than that in NGT group (9.67 鹵6.59) pg/ml (P0.01). The level of serum PLGF in T2DM MVC group was significantly higher than that in T2DM group and MVC group (P0.01). There was no significant difference in serum PLGF level between T2DM group and MVC group (P < 0.01). There was no significant difference in serum PLGF level and FPG,TC,TG,Hb A1c between T2DM group and MVC group (P < 0.01). Hs-CRP was positively correlated (r = 0.486,0.300,0.217,0.427,0.519, P0.05). Serum PLGF level was positively correlated with hs-CRP,TC,LDL-C (r = 0.444, 0.390, 0.278, P0.05) and negatively correlated with fasting C-peptide (r = 0.332, P0.05) in type 2 diabetic patients. There was a positive correlation between serum PLGF level and FPG,Hb A1c, hsc CRP (r = 0.661, 0.625, 0.352, P0.05). (3) Logistic regression analysis showed that PLGF,LDL-C,hs-CRP was a risk factor for atherosclerosis. HDL-C is a protective factor of atherosclerosis. Conclusion: (1) the level of serum PLGF in patients with type 2 diabetes mellitus and simple atherosclerosis is higher than that in normal controls, and the level of serum PLGF in patients with macrovascular complications of type 2 diabetes mellitus is further higher than that in patients with type 2 diabetes mellitus. Combined with the positive correlation between serum PLGF level and hs-CRP, it is suggested that PLGF may promote the occurrence and development of diabetes mellitus and its macrovascular complications by participating in inflammatory reaction in the pathogenesis of type 2 diabetes and atherosclerosis. Therefore, PLGF may be an early predictor of macrovascular complications in type 2 diabetes mellitus and provide a new possible entry point for early intervention. (2) PLGF is positively correlated with fasting blood glucose, various lipid components, and hs-CRP. Therefore, by means of reducing blood sugar, regulating blood fat and controlling body weight, the level of serum PLGF may be reduced, thereby delaying the occurrence and development of diabetes mellitus and its macrovascular complications and reducing the occurrence of life-threatening cardiovascular and cerebrovascular events.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.2

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相關(guān)期刊論文 前1條

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