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1.
目的:研究糖尿病(Diabetes Mellitus,DM)患者血小板体积(mean platelet volume,MPV)和血清脂联素水平与冠心病的关系。方法:选取研究对象共150例分为三组,其中101名糖尿病患者根据冠脉造影结果分为:A组(糖尿病合并冠心病组)共72人,B组(糖尿病非冠心病组)共29人。对照组为排除糖尿病且冠脉造影正常者共49人。入院次日检测空腹血常规(含MPV),应用ELISA法检测各组血清脂联素水平。应用Gensini评分系统评估冠状动脉的狭窄程度。结果:A组和B组的脂联素水平均低于对照组(P0.05),且A组脂联素水平低于B组(P0.05)。A组与B组MPV水平均高于对照组(P0.05),且A组MPV水平高于B组(P0.05)。相关性分析显示Gensini评分与脂联素水平负相关(r=-0.59,P0.001),Gensini评分与MPV正相关(r=0.56,P0.001)。结论:脂联素、MPV与糖尿病合并冠心病的发生显著相关,而脂联素可能通过拮抗糖尿病患者血小板活性程度,延缓心血管并发症的发生。 相似文献
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脂联素(adiponectin)是一种由脂肪细胞特异性高分泌,具有多种生物学功能的特殊蛋白质它直接作用于肝脏、骨骼肌和血管,能提高胰岛素敏感性,增强脂肪酸β氧化,抵制血管炎症反应,最新研究还发现脂联素和骨生成密切相关。与其它脂肪因子不同的是,循环中脂联素的浓度与人体脂肪含量成反比,会因TNF-α的作用而上调,会被噻唑烷二酮类药物所抑制,还受到胰岛素抵抗和炎症反应的影响脂联素受体有2类,分别为AdipoR1和AdipoR2,AdipoR1主要分布在骨骼肌上,AdipoR2则高表达于肝脏组织。本文主要综述了脂联素及其受体的结构、生物学功能和研究进展。 相似文献
3.
脂肪组织过去一直被认为仅仅是体内的—个能量储存池。然而,近十年来的研究表明,它还是机体重要的内分泌器官之一。它所分泌的一些激素对胰岛素的敏感性及其生理过程起着重要的调节作用,脂联素(Adiponectin)就是其中重要的一种。它于1995被发现后, 相似文献
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目的:检测血清脂联素(APN)水平,分析血清APN浓度与血脂、血清载脂蛋白A5(apoA5)及2型糖尿病的关系。方法:收集2型糖尿病(T2DM)210例,健康体检者112例,采用ELISA法检测血浆脂联素水平,双抗体夹心ELISA法检测血清载脂蛋白A5(apoA5)水平,7600-020E全自动生化分析仪检测总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等,放射免疫分析仪检测血胰岛素水平。结果:T2DM患者血清APN浓度明显低于健康对照组,LDL-C、TG及TC均高于对照组(P<0.05)。T2DM患者血清apoA5浓度(200.3±51.2)ng/ml,显著低于健康对照组(229.8±56.5)ng/ml,P<0.05。Pearson相关分析显示经年龄、性别校正后APN水平与LDL-C、TG呈负相关,与HDL-C呈正相关;T2DM组APN与apoA5呈正相关(P<0.05)。结论:T2DM患者血清APN水平显著降低,本研究证实低水平血清APN和apoA5不仅与血脂代谢密切相关,还可作为T2DM患者早期监测的指标,对其预后评价具有积极的意义。 相似文献
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目的:探讨脂联素在肝源性糖尿病患者胰岛素抵抗中的作用.方法:检测肝源性糖尿病(A组)、肝硬化(B组)、2型糖尿病(C组)患者及正常人(D组)血清脂联素(ADPN)、空腹血糖(FPG)、空腹胰岛素(FINS)水平,计算其胰岛素抵抗指数(HOMA-IR)、β细胞功能指数(FBCI)、胰岛素敏感性指数(ISI),分析ADPN与胰岛素抵抗的相关性.结果:A组ADPN水平低于B组、D组(P<0.05);FPG水平低于C组(P<0.05);FINS,FBCI水平高于C组及D组(P<0.05);ISI低于D组(P<0.05);HOMA-IR显著高于B组及D组(P<0.05).ADPN与 FPG、FINS、HOMA-IR呈负相关;与ISI呈正相关.结论:肝源性糖尿病患者ADPN水平下降,其与胰岛素抵杭呈负相关,提示脂联素可能在肝源性糖尿病患者胰岛素抵抗中起着重要作用. 相似文献
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脂联素是近年来发现的具有抗冠状动脉粥样硬化作用的脂肪因子,它是脂肪细胞分泌的一种蛋白质,分别在粥样斑块形成早期、粥样斑块形成过程中和粥样斑块的稳定性等多个方面发挥抗粥样硬化的作用.脂联素的抗粥样硬化机制是一个复杂的病理生理机制,包括维护动脉内皮细胞的正常功能、抑制巨噬细胞和平滑肌细胞的迁移和增生、稳定粥样斑块等.脂联素的抗动脉粥样硬化作用显示了巨大的临床应用潜力. 相似文献
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脂联素基因单核苷酸多态性与Ⅱ型糖尿病合并肥胖及胰岛素抵抗相关联 总被引:1,自引:0,他引:1
脂联素是近年新发现的脂肪组织特异性的细胞因子,其mRNA是脂肪组织中含量最丰富的基因转录产物,该因子可通过多种途径影响个体对胰岛素的敏感性。脂联素基因多态性与肥胖、胰岛素抵抗和2型糖尿病密切相关,而与冠心病相关性研究的报道较少。本研究以中国汉族人群1,098例为对象,其中304例冠心病(CHD)患者,389例糖尿病患者(T2DM),及405例性别年龄相匹配的正常对照,采用PCR-RFLP技术对脂联素基因-4522C/T进行基因分型,并分别对血脂水平、胰岛素抵抗、体重指数等临床数据进行分析比较。研究结果显示,脂联素基因-4522C/T各基因型及等位基因在CHD组与对照组、T2DM组与对照组中的分布差异无显著性;经分组分析发现,T2DM合并肥胖患者BMI≥25kg/m2TT基因型及T等位基因明显多于对照组,差异有显著性,P=0.014和P=0.034;TT基因型T2DM患者胰岛素抵抗指数(HOMA-IR)显著高于携带有C等位基因的T2DM患者,P=0.0069。本研究提示脂联素基因-4522C/T与中国汉族人群T2DM合并肥胖的发生及T2DM患者胰岛素抵抗相关,是引发糖尿病患者肥胖和胰岛素抵抗的重要候选基因,而与冠心病的发生无关联。 相似文献
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脂联素是人和动物体内重要的内源性生物活性激素,具有改善胰岛素抵抗、调控脂类代谢、抗动脉粥样硬化、保护心脏、抗炎、抗氧化应激、抗纤维化以及调控细胞凋亡等作用。脂联素需要与其受体结合才能发挥生物学功能,但因其结构和浓度的影响,脂联素在临床上的应用受到一定程度限制。研究发现,多种脂联素受体激动剂通过激活脂联素受体发挥与脂联素相似的生物学功能,且脂联素受体激动剂多为人工合成的小分子或筛选的多肽,作用效果更加明确。本文整理了目前已经报道的脂联素受体激动剂及其研究进展,概述了脂联素受体激动剂对肝脏、肾脏、心脏、血管、眼和皮肤等相关器官或组织疾病的作用或影响,为开发以脂联素及其受体为靶点的治疗药物提供理论依据。 相似文献
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摘要:目的 探讨糖化白蛋白(GA)和脂联素(APN)检测在妊娠期糖尿病(GDM)诊断中的应用价值。方法 选取2012年6月至2013年12月来院检查的妊娠女性,在24~28周时确诊妊娠期糖尿病组120例,正常妊娠组30例。采用酶法测定GA、空腹血糖(FPG)和餐后2 h血糖(2hPG),采用双抗体夹心ELASA法测量脂联素,并比较其在两组间的区别。结果 GDM组GA、FPG和2hPG显著高于正常妊娠组,脂联素水平正常妊娠组显著高于GDM组(P<0.05)。单独检测GA的敏感性、特异性和准确性分别为86.7%、93.3%和88.0%,APN的敏感性、特异性和准确性分别为79.2%、90%和81.3%,联合检测能提高到91.7%、96.7%和92.7%。结论 GA和APN与GDM发生密切相关,两者联合检测能提高阳性检出率。 相似文献
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Lorena Ortega Moreno Olga Lamacchia Massimiliano Copetti Lucia Salvemini Concetta De Bonis Salvatore De Cosmo Mauro Cignarelli Vincenzo Trischitta Claudia Menzaghi 《PloS one》2015,10(10)
High serum adiponectin has been increased in several conditions of kidney disease. Only sparse and conflicting results have been reported in patients with type 2 diabetes (T2D), a subgroup of individuals who are at high risk for renal dysfunction. The aim of this study was to fill up this gap of knowledge by investigating such association in a large sample of Italian diabetic patients. The association between serum adiponectin levels and estimated glomerular filtration rate (eGFR by Chronic Kidney Disease-Epidemiology Collaboration CKD-EPI equation) was investigated in 1,243 patients with T2D from two cross-sectional Italian studies: 878 from San Giovanni Rotondo (SGR) and 365 from Foggia (FG). Serum adiponectin was inversely associated with eGFR in SGR [β (standard error, SE) for 1 standard deviation (SD) of adiponectin = -3.26 (0.64)] and in FG [β(SE)=-5.70(1.28)] sample, as well as in the two studies combined [β(SE)=-3.99(0.59)];(p<0.0001 for all). In this combined analysis, the association was still significant after adjusting for sex, smoking habits, body mass index (BMI), waist circumference, diabetes duration, glycated hemoglobin (HbA1c), albumin creatinine ratio (ACR) and anti-hyperglycemic, anti-hypertensive and anti-dyslipidemic treatments [β (SE)= -2.19 (0.59), p = 0.0001]. A stronger association between each SD adiponectin increment and low eGFR was observed among patients with micro-/macro-albuminuria, as compared to those with normo-albuminuria [adjusted β(SE)=-4.42(1.16) ml/min/1.73m2 vs. -1.50 (0.67) ml/min/1.73m2, respectively; p for adiponectin-by-albuminuric status = 0.022]. For each adiponectin SD increment, the odds of having eGFR < 60 ml/min/1.73m2 increased by 41% (odds ratio, OR = 1.41; 95% confidence interval, CI 1.21–1.64) in SGR sample, 53% (OR = 1.53; 95% CI 1.21–1.94) in FG sample, and 44% (OR = 1.44; 95%CI 1.27–1.64) in the two studies considered together (p<0.0001 for all). In the combined sample, further adjustment for the above mentioned covariates did not change the observed association (OR = 1.36; 95%CI 1.16–1.60; p<0.0001). Our study, so far the largest addressing the relationship between serum adiponectin and GFR in T2D, strongly suggests that the paradoxical inverse association, previously reported in different clinical sets, is also observed in diabetic patients. Further studies are needed to unravel the biology underlying this counterintuitive relationship. 相似文献
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摘要 目的:探讨2型糖尿病(T2DM)患者血清Sestrin2水平与心血管疾病(CVDs)的关系及其预测价值。方法:选取2017年9月-2020年7月中国人民解放军东部战区总医院收治的198例T2DM患者,根据随访2年内CVDs发生情况分为非CVDs组(n=106)与CVDs组(n=92),比较两组血清Sestrin2水平、一般资料及实验室指标,多因素Logistic回归分析T2DM并发CVDs的影响因素,受试者工作特征(ROC)曲线分析血清Sestrin2水平对T2DM并发CVDs的预测效能。结果:与非CVDs组比较,CVDs组体质量指数(BMI)、收缩压(SBP)、舒张压 (DBP)、尿酸(UA)、餐后2 h胰岛素(2hINS)、餐后2 h C肽(2hCP)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、Sestrin2明显增高(P<0.05),而两组在糖尿病病程、腰围、年龄、性别、吸烟史、血尿素氮(BUN)、饮酒史、血肌酐(SCr)、餐后2 h血糖(2hPG)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖、空腹胰岛素、心血管疾病家族史方面比较差异无统计学意义(P>0.05)。多因素Logistic回归模型结果显示,BMI、UA、2hINS、2hCP、Sestrin2水平增高为T2DM并发CVDs的危险因素(P<0.05)。绘制ROC曲线发现,血清Sestrin2对T2DM并发CVDs的预测效能较高,其曲线下面积(AUC)(95%CI)为:0.729(0.472~0.984),临界点为10.35 ng/mL。结论:血清Sestrin2在T2DM并发CVDs患者中呈高表达,与T2DM并发CVDs风险增加有关,其辅助临床预测T2DM患者并发CVDs风险的价值较高。 相似文献
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摘要 目的:探讨血清补体1q/肿瘤坏死因子相关蛋白(CTRP)4、CTRP5、CTRP6与2型糖尿病(T2DM)合并冠心病(CHD)患者冠状动脉病变的关系。方法:选取2021年3月~2021年7月我院收治的100例T2DM合并CHD患者为合并组,根据SYNTAX评分分为中重度病变组44例和轻度病变组56例,选取同期收治的100例单纯T2DM患者为T2DM组,另选取同期体检健康志愿者80名为对照组。采用酶联免疫吸附法检测血清CTRP4、CTRP5、CTRP6水平。采用Spearman相关性分析T2DM合并CHD患者SYNTAX评分与血清CTRP4、CTRP5、CTRP6水平的相关性,多因素Logistic回归分析T2DM合并CHD患者冠状动脉中重度病变的影响因素。结果:对照组、T2DM组、合并组血清CTRP4、CTRP5水平依次升高,CTRP6水平依次降低(P<0.05)。Spearman相关性分析显示,T2DM合并CHD患者SYNTAX评分与血清CTRP4、CTRP5水平呈正相关(rs=0.820、0.833,P均<0.001),与CTRP6水平呈负相关(rs=-0.838,P<0.001)。多因素Logistic回归分析显示,T2DM病程延长和糖化血红白蛋白(HbA1c)、CTRP4、CTRP5升高为T2DM合并CHD患者冠状动脉中重度病变的独立危险因素,CTRP6升高为独立保护因素(P<0.05)。结论:血清CTRP4、CTRP5水平升高和CTRP6水平降低与T2DM合并CHD患者冠状动脉病变加重独立相关,可能成为T2DM合并CHD患者冠状动脉病变评估指标。 相似文献
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目的:本研究旨在探讨质子泵抑制剂(vii)对心内科拟诊断为冠心病患者的嗜铬粒蛋白A(CgA)水平影响的临床意义。方法:113名拟诊冠心病的住院患者,分为PPI组(药物治疗中加入PPI,共62例)和非PPI组(药物治疗中无PPI,共51例),收集其外周血清,用ELISA法检测样本血清中CgA水平,同时应用化学发光法检测样本血清中NT—proBNP水平。比较PPI组和非PPI组CgA、NT.proBNP水平的差异。结果:因为CgA、NT.proBNP均为非正态分布资料,两者均通过对数转换为正态分布资料;PPI组的LNCgA的均数显著高于非PPI组(4.62±0.97和3.91±0.89,P=0.000)。而两组LNNT-proBNP的均数无显著差异(5.41±1.46和5.59±2.00,P=0.580)。结论:在心功能等临床特征具有可比性的情况下,是否使用PPI对CgA水平的影响很大;而对BNP无明显影响。评价CgA在心功能分级或冠心病预后等方面的应用,不能忽略PPI联用对CgA数值的影响。 相似文献
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目的:本研究旨在探讨质子泵抑制剂(PPI)对心内科拟诊断为冠心病患者的嗜铬粒蛋白A(CgA)水平影响的临床意义。方法:113名拟诊冠心病的住院患者,分为PPI组(药物治疗中加入PPI,共62例)和非PPI组(药物治疗中无PPI,共51例),收集其外周血清,用ELISA法检测样本血清中CgA水平,同时应用化学发光法检测样本血清中NT-proBNP水平。比较PPI组和非PPI组CgA、NT-proBNP水平的差异。结果:因为CgA、NT-proBNP均为非正态分布资料,两者均通过对数转换为正态分布资料;PPI组的LN CgA的均数显著高于非PPI组(4.62±0.97和3.91±0.89,P=0.000)。而两组LN NT-proBNP的均数无显著差异(5.41±1.46和5.59±2.00,P=0.580)。结论:在心功能等临床特征具有可比性的情况下,是否使用PPI对CgA水平的影响很大;而对BNP无明显影响。评价CgA在心功能分级或冠心病预后等方面的应用,不能忽略PPI联用对CgA数值的影响。 相似文献
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《Endocrine practice》2016,22(11):1310-1318
Objective: To investigate whether serum carcinoembryonic antigen (CEA) levels are associated with type 2 diabetes mellitus (T2DM) and glycated hemoglobin (HbA1c).Methods: A comparative, cross-sectional, observational study was conducted at Jordan University Hospital, Amman, Jordan, on 282 adult subjects from March 2012 to June 2015. Subjects were classified into 2 groups: T2DM subjects (n = 168) and a healthy comparison group (n = 114). Subjects with any condition known to be associated with elevated CEA levels were excluded. HbA1c and serum CEA levels were measured, and body mass index (BMI) was determined.Results: Subjects with T2DM had significantly higher mean serum CEA than controls (2.4 ± 1.5 vs. 1.5 ± 1.2 ng/mL, P<.0001). Sex did not correlate with CEA levels, while age (Spearman's rho [ρ] = 0.18, P =.002) and HbA1c (ρ = 0.56, P<.0001) did; however, age no longer correlated after correcting for diabetic status. HbA1c was the only variable shown to correlate with CEA in a stepwise linear regression (r = 0.37, P<.001).Conclusion: We observed a statistically significant association between elevated CEA and T2DM, despite average CEA values for both groups being within the reference range. In addition, serum CEA levels correlated positively with HbA1c values.Abbreviations:ADA = American Diabetes AssociationBMI = body mass indexCA 19-9 = carbohydrate antigen 19-9CEA = carcinoembryonic antigenCRP = C-reactive proteinDM = diabetes mellitusHbA1c = glycated hemoglobinJUH = Jordan University HospitalT2DM = type 2 diabetes mellitusρ = Spearman's correlation coefficient 相似文献
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Farrokhian Alireza Mahmoodian Mina Bahmani Fereshteh Amirani Elaheh Shafabakhsh Rana Asemi Zatollah 《Biological trace element research》2020,194(2):313-320
Biological Trace Element Research - This investigation was conducted to determine the effects of chromium supplementation on metabolic status in diabetic patients with coronary heart disease (CHD).... 相似文献
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Lorena Ortega Moreno Lucia Salvemini Christine Mendonca Massimiliano Copetti Concetta De Bonis Salvatore De Cosmo Alessandro Doria Vincenzo Trischitta Claudia Menzaghi 《PloS one》2015,10(3)
BackgroundHigh serum levels of the pro-inflammatory adipokine resistin have been associated with decreased renal function in the general population. The goal of this study was to investigate whether such association is also present among diabetic subjects, who are at increased risk of renal function loss.MethodsThe cross-sectional association between serum resistin levels and estimated glomerular filtration rate (eGFR) was investigated in 1,560 type 2 diabetic (T2D) patients of European ancestry comprised in two different cohorts: 762 patients from San Giovanni Rotondo (SGR; Italy) and 798 patients from Boston (US).ResultsSerum resistin was inversely associated with eGFR in SGR [β (SE) for one SD of resistin increment = -1.01 (0.70) ml/min/1.73m2, p = 0.019] and in Boston [β (SE) = -5.31 (0.74) ml/min/1.73m2, p < 0.001] samples, as well as in the two studies combined [β (SE) = -3.42 (0.52) ml/min/1.73m2, p < 0.001]. The association was unaffected by adjustment for smoking habits, BMI, waist circumference, diabetes duration, HbA1c, insulin treatment, hypertension and lipid-lowering therapy: β (SE) for one SD of resistin increment = -1.07 (0.70), p = 0.02; -5.50 (0.88), p < 0.001; and -2.81 (0.55) ml/min/1.73m2, p < .001, in SGR, Boston and the two studies combined, respectively. The association was significantly stronger in men than in women (p for resistin-by-gender interaction = 0.003). For each resistin SD increment, the odds of having eGFR < 0 ml/min/1.73m2 increased by 22% (OR = 1.22; 95% CI 1.02–1.44; p = 0.025) in SGR sample, 69% (OR = 1.69; 95% CI 1.38–2.07; p < 0.001) in Boston sample, and 47% (OR = 1.47; 95% CI 1.29–1.68; p < 0.001) in the two studies considered together. Similar associations were observed in the adjusted model: OR 95% CI for each SD resistin increment being 1.23 (1.03–1.46), p = 0.021; 1.52 (1.20–1.92), p < 0.001; 1.33 (1.16–1.53), p < 0.001, in SGR, Boston and the two studies combined, respectively.ConclusionsThis is the first report of an association between high serum resistin and low eGFR in patients with T2D of European ancestry. 相似文献
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Objective
Patients with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) have a higher prevalence of cardiovascular diseases. In this study we investigated the frequency of single nucleotide polymorphisms (SNPs) of several candidate genes associated with NAFLD in Taiwanese patients with type 2 diabetes mellitus (DM) and NAFLD and in those with DM but without fatty liver disease.Methods
We enrolled 350 patients with type 2 DM and NAFLD and 209 patients with DM but without NAFLD. Body mass index (BMI), % body fat (% BF), glycated hemoglobin (HbA1c), high molecular weight (HMW) isoform of adiponectin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) levels were measured. Thirteen SNPs in 5 genes (adiponectin, leptin, peroxisome proliferator-activated receptor alpha, adiponutrin/patatin-like phospholipase domain-containing protein 3 and peroxisome proliferator-activated receptor γ co-activator 1α ) were measured.Results
Only adiponectin rs266729 polymorphism was associated with susceptibility to NAFLD (p = 0.001). Subgroup analysis revealed that the proportion of subjects with homozygous genotype GG was higher in patients with NAFLD (31%) than in controls (11%) and that the proportions of heterozygous CG and homozygous CC were higher in controls (37% and 52%, respectively) than in patients with NAFLD (33% and 36%, respectively). Patients with NAFLD carrying the GG genotype of rs266729 showed significantly lower serum HMW adiponectin levels than patients carrying the GC or CC genotype (3.75±0.37 vs. 3.99±0.66 vs. 4.79±0.58 μg/ml, p< 0.001). Body fat and serum HMW adiponectin levels were the strongest predictors of developing NAFLD (p < 0.001 and 0.004, respectively).Conclusions
In patients with type 2 diabetes gene polymorphism of adiponectin rs266729 is associated with risk of NAFLD. G allele of rs266729 is associated with hypoadiponectinemia. Low serum adiponectin level may precipitate liver steatosis in patients with type 2 diabetes. 相似文献20.
目的:探讨冠心病心力衰竭患者颈股搏波传导速度(cfPWV)及血清脑钠肽(BNP)水平与冠状动脉病变程度的相关性及其对患者预后的预测价值。方法:选择冠心病心力衰竭患者90例,依据心脏彩超EF值分别分为三组,A组(EF值>40%),B组(30%0.05)。C组的cfPWV明显快于A、B两组,存在显著性差异(P<0.05),A、B组间无统计学差异(P>0.05)。三组间收缩压、Gensini积分和血清BNP水平比较存在统计学差异(P<0.05)。A、B组间脉压比较无统计学差异(P>0.05),C组与A组、B组脉压比较均存在统计学差异(P<0.05)。CfPWV与血清BNP水平、Gensini积分呈正相关。cfPWV对冠心病心力衰竭患者预后的ROC曲线下面积为0.617,其预测冠心病心力衰竭患者发生不良事件的灵敏度为81.8%,特异性为60.9%;血清BNP水平对冠心病心力衰竭患者预后的ROC曲线下面积为0.767,其预测冠心病心力衰竭患者发生不良事件的灵敏度为93.2%,特异性为56.5%。结论:cfPWV与血清BNP水平、冠状动脉病变程度之间具有相关性,cfPWV对冠心病心力衰竭患者发生不良事件具有中等的预测价值,但其敏感性及特异性有限。 相似文献