2型糖尿病患者血清RANTES与下肢大血管病变的相关性

目的:探讨2型糖尿病(T2DM)患者血清RANTES与下肢大血管病变的相关性.方法:(1)T2DM 61例,根据是否合并下肢大血管病变,分为非下肢大血管病变组(30例)和下肢大血管病变组(31例),与正常对照组20例比较,采用双抗体夹心ELISA法测定血清RANTES,比较三组间血清RANTES水平的差异.(2)测定各组TG、TC、LDL、Hd1-ch、、FPG、HbA1c、FIB等水平,分析其与2型糖尿病大血管病变的相关性.结果:(1)2型糖尿病组血清RANTES水平明显高于正常对照组(P<0.05),下肢大血管病变组血清RANTES水平明显高于非下肢大血管病变组和正常对照组(P<0.05),(2)以T2DM组为整体,有无下肢大血管病变为因变量Y(有=1,无=0),以RANTES等其它危险因素为自变量,进行Logstic回归分析,SBP、病程和RANTES入回归方程.结论:RANTES可能是T2DM下肢大血管病变的一个重要的独立危险因素.     

2型糖尿病大血管病变患者血清趋化素与hs-CRP的相关性

目的:观察2型糖尿病(type2 diabetes mellitus,T2DM)大血管病变患者血清趋化素(chemerin)和超敏C-反应蛋白(high-sensitivity C-reactive protein,hs-CRP)的水平及其相关性。方法:选择我院2013年4月至2015年4月收治的T2DM患者60例,根据患者血管病变情况分为糖尿病大血管病变组和单纯糖尿病组,每组30例。另选择同期来我院体检的健康志愿者30例作为对照组。检测三组血清chemerin和hs-CRP水平并分析。结果:糖尿病大血管病变组和单纯糖尿病组血清chemerin和hs-CRP水平均显著高于对照组(P0.05);糖尿病大血管病变组血清chemerin和hs-CRP水平均显著高于单纯糖尿病组(P0.05);糖尿病大血管病变组血清chemerin与hs-CRP呈正相关(r=0.451,P0.05)。结论:T2DM大血管病变患者血清chemerin水平显著增高,血清chemerin水平与炎症指标hs-CRP存在正相关,chemerin可能通过介导炎症在T2DM大血管病变过程中发挥作用。     

2 型糖尿病患者血浆成纤维细胞生长因子-21 水平的变化及意义

目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血浆成纤维细胞生长因子-21(fibroblast growth factor 21,FGF-21)水平变化以及观察短期胰岛素强化治疗对FGF-21水平的影响。方法:选择我院2013年1月至2015年1月收治的T2DM患者64例,其中初诊T2DM患者32例(T2DM组),T2DM合并大血管病变患者32例(合并大血管病变组),并选择同期体检健康者30例(对照组)。采用酶联免疫法测定三组血浆FGF-21水平以及胰岛素强化治疗前后的变化,分析血浆FGF-21水平与体质量指数(BMI)、腰臀比(WHR)、血脂、血糖、空腹血浆胰岛素(FINS)和糖化血红蛋白(Hb A1C)等水平的关系。结果:T2DM组及T2DM合并大血管病变组患者空腹血浆FGF-21水平明显高于对照组(P0.05),T2DM合并大血管病变组患者空腹血浆FGF-21水平明显高于T2DM组和对照组(P0.05)。空腹血浆FGF-21水平与T2DM患者FPG、Hb A1C水平呈明显正相关,WHR、舒张压、Hb A1C是影响血浆FGF-21水平的独立相关因素。经胰岛素强化治疗后,血浆FGF-21水平较治疗前明显下降(P0.05)。结论:T2DM患者血浆FGF-21水平明显升高,可能参与了T2DM及其大血管病变的发生和发展,胰岛素强化治疗可明显降低T2DM患者血浆FGF-21水平,血浆FGF-21可能作为T2DM病情和疗效评估的参考指标。     

2型糖尿病发生大血管并发症的危险因素分析

目的:探讨2型糖尿病患者发生大血管并发症的危险因素.方法:选取哈尔滨医科医科大学附属第四医院内分泌科2012年1月至2012年12月住院的2型糖尿病患者共计200例,根据相关辅助检查结果将其分为2型糖尿病无大血管并发症(DMl)组和2型糖尿病合并大血管并发症(DM2)组,比较2组患者血清胆红素水平及相关指标的差异.应用多因素非条件Logistic回归分析法对2型糖尿病大血管并发症危险因素建立方程.结果:2型糖尿病合并大血管并发症组患者血清胆红素水平低于2型糖尿病无大血管并发症组(P＜0.01),以糖尿病合并大血管并发症为因变量,年龄、病程、糖化血红蛋白、低密度脂蛋白胆固醇、甘油三酯、总胆红素、总胆固醇、直接胆红素、间接胆红素水平为自变量,进行Logistic逐步回归分析,结果显示病程、血清低密度脂蛋白胆固醇、年龄和总胆固醇是2型糖尿病合并大血管并发症的独立危险因素,血清胆红素水平是其保护性因素.结论:病程、年龄、血清低密度脂蛋白胆固醇和总胆固醇水平是2型糖尿病合并大血管并发症的独立危险因素,而血清胆红素水平是其保护性因素.     

2型糖尿病患者血糖波动与心律失常和下肢血管病变的关系及其影响因素分析

目的:探讨2型糖尿病(T2DM)患者血糖波动与心律失常和下肢血管病变的关系,分析影响T2DM心律失常和下肢血管病变的因素。方法:选择2019年7月到2020年6月我院收治的82例T2DM患者,根据是否合并心律失常分为心律失常组28例和无心律失常组54例,根据是否合并下肢血管病变分为下肢血管病变组31例和无下肢血管病变组51例。所有患者均通过72 h监测血糖获得日内平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)、全天血糖标准差(SDBG)、全天血糖波动次数(NGE)。比较组间差异,分析影响T2DM患者心律失常和下肢血管病变的因素。结果:心律失常组MAGE、MODD、SDBG、NGE、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、T2DM病程、同型半胱氨酸(Hcy)、丙二醛(MDA)高于无心律失常组(P<0.05)。下肢血管病变组T2DM病程、Hcy、MDA、HOMA-IR、MAGE、MODD、SDBG、NGE均高于无下肢血管病变组(P<0.05)。Logistic回归分析结果显示MDA、HOMA-IR、MAGE、MODD是T2DM患者心律失常的危险因素(P<0.001),MAGE、MODD、SDBG是T2DM患者下肢血管病变的危险因素(P<0.001)。结论:T2DM患者血糖波动与心律失常和下肢血管病变均有关,血糖波动增加是T2DM心律失常和下肢血管病变的危险因素。     

2型糖尿病患者血浆chemerin水平与其冠脉病变程度的相关性分析

目的:探讨2型糖尿病患者血浆趋化素(chemerin)水平与冠脉病变程度的关系。方法:选取2011年1月~2012年2月我院收治的2型糖尿病(T2DM)患者92例,均行冠状动脉造影检查。按冠状动脉造影结果分为单纯2型糖尿病无冠状动脉病变组26例(DM0);合并单支冠状动脉病变组32例(DM1);合并双支以上病变组34例(DM2)。另选取正常健康行冠脉造影检查者25例作为正常对照组(NC)。采用酶联免疫吸附法检测各组入选者血浆chemerin水平,并分析其与冠脉病变程度的相关性。结果:T2DM及T2DM合并冠状动脉病变患者血浆chemerin水平与NC组对比均明显升高,并且与冠状动脉病变严重程度呈正相关(P0.05)。各组血浆Chemerin水平与BMI、HOMA-IR、TC、和APOB各指标间呈显著正相关(r分别为0.781、0.723、0.415、0.694,P均0.01)。结论:2型糖尿病患者冠状动脉病变的发生发展可能与血浆chemerin升高有关。     

彩色多普勒超声对糖尿病性大血管病变中血管狭窄程度和分布区域的诊断效果

目的:探讨彩色多普勒超声对糖尿病性大血管病变(DMD)血管狭窄程度和分布区域的诊断价值。方法:选择2015年1月到2017年1月在来院就诊的180例有2型糖尿病(T2DM)或大血管病变的患者作为研究对象,T2DM合并大血管病变者60例记为A组,大血管病变非T2DM者60例记为B组,单纯T2DM者60例记为C组。另选同期在医院接受健康体检的志愿者60例作为对照组,记为D组。检测对比A、B两组经彩超及血管造影检查的结果,分析影响DMD的单因素及危险因素。结果:A组的下肢动脉病变、血管狭窄检出率、严重狭窄检出率及≥3支血管病变检出率均较B组明显更高,而颈总动脉病变的检出率较B组明显更低,差异均有统计学意义(均P0.05)。A、C两组的血糖(FPG)、糖化血红蛋白(Hb A1c)、脂肪因子(Vaspin)及内脂素(Visfatin)水平均较D组明显更高,而A组以上指标又明显高于C组,差异均有统计学意义(均P0.05)。A、C两组的甘油三酯(TG)、8-异前列腺素(8-iso-PGF2α)及内皮素(ET)水平较D组明显更高,且A组较C组明显更高,差异均有统计学意义(均P0.05)。Logistic回归分析法分析显示影响DMD的危险因素有FBG、TG、8-iso-PGF2α及ET。结论:彩超对于DMD的诊断价值较好,此类病变的分布区域主要位于患者的下肢动脉,且影响DMD的危险因素有FBG、TG、8-iso-PGF2α及ET。     

2型糖尿病合并非酒精性脂肪肝患者的临床特征及与慢性并发症的关系研究

目的:探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者的临床特征,并分析其与糖尿病慢性并发症的关系。方法:选取2016年1月至2017年1月期间来我院就诊的T2DM患者245例作为研究对象,根据肝胆超声和生化检查结果,将单纯T2DM患者105例作为对照组,将T2DM合并NAFLD患者140例作为观察组,对比两组的一般情况和生化指标,并采用单因素和多因素Logistic回归分析T2DM合并NAFLD与大血管慢性病的关系。结果:与对照组比较,观察组病程较短,HDL-C水平较低,BMI、SBP、TC、TG、LDL-C、ALT、AST、HbA1c、FINS、INS-120、HOMA-IR、FPG、2 h PG、空腹C肽、餐后2 h C肽水平较高(P0.05)。观察组大血管发病率明显高于对照组(P0.05)。Logistic回归分析结果显示,T2DM合并NAFLD患者合并大血管慢性病的影响因素依次是:BMI、HOMA-IR、SBP、LDL-C、HbA1c、TG。结论:合并NAFLD的T2DM患者糖尿病大血管慢性病发病率显著增加,合并NAFLD的影响因素依次为BMI、HOMA-IR、SBP、LDL-C、HbA1c、TG。     

2型糖尿病患者微血管病变与血清代谢学指标的关系

目的:探讨2型糖尿病(T2DM)患者微血管病变与血清代谢学指标的关系。方法:选择我院于2015年7月~2016年7月间收治的T2DM患者共96例,按是否存在微血管病变分为观察组(n=43,存在微血管病变)及对照组(n=53,无微血管病变)。检测并对比两组患者血清中三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖(FBG)、糖化血红蛋白(HbA1C)、同型半胱氨酸(Hcy)、血清胱抑素C(CysC)及血管内皮生长因子(VEGF)水平,并采用logistic回归分析T2DM微血管病变的危险因素。结果:观察组病程、吸烟率高于对照组,差异有统计学意义(P0.05);观察组TG、LDL、HbA1C、CysC、Hcy、VEGF水平均高于对照组,差异均有统计学意义(P0.05);两组TC、HDL水平比较,差异无统计学意义(P0.05);经logistic回归分析显示,病程、CysC、Hcy、VEGF为微血管病变的危险因素(OR=1.975,3.643,4.054,4.214,P0.05)。结论:CysC、Hcy、VEGF为微血管病变的危险因素,对其水平的检测有助于早期T2DM微血管病变诊断及治疗。     

血清TNF-α与糖尿病微血管病变的关系

目的:研究肿瘤坏死因子α(tumor necrosis factor-alpha;TNF-α)与糖尿病微血管病变的关系.方法:将67例糖尿病患者,通过是否合并微血管痛变,分成无微血管病变组(DMI组)32例,合并微血管病变组(DM2组)35例,设正常时照组25例对比,用放射免疫法测得血清TNF-α,三组间进行比较.测受检者总胆固醇、甘油三酯、空腹血糖、糖化血红蛋白等指标,三组间比较.结果:2型糖尿病患者肿瘤坏死因子-α水平显著高于正常对照组(P＜0.01),糖尿病合并微血管病变组较糖尿病无微血管病变组其表达也明显升高(P＜0.01).结论:TNF-α表达的上调可能与糖尿病微血管病变的发生、发展关系密切     

The 223A>G polymorphism of the leptin receptor gene is associated with macroangiopathy in type 2 diabetes mellitus

To determine whether leptin receptor (LEPR) 223A>G polymorphism has an effect on the plasma leptin levels and the macroangiopathic complications in type 2 diabetes mellitus (T2DM). The genotypes and allelic frequencies of the LEPR 223A>G were examined with polymerase chain reaction and restriction fragment length polymorphism in 301 patients with T2DM and 172 unrelated healthy subjects. The plasma concentrations of leptin were determined in all subjects. The mean plasma leptin levels in the T2DM group were significantly higher than that of controls and the plasma levels of leptin were higher in diabetic patients with macroangiopathy than in patients without macroangiopathy (P < 0.05). The genotype (GG, AG and AA) distribution of 223A>G polymorphism was 58.3, 32.5, and 9.2% in diabetic patients with macroangiopathy, 75.3, 22.1, and 2.6% in patients without macroangiopathy, and 70.3, 27.5, 2.2% in controls respectively, a significant difference was found between diabetic patients with and without macroangiopathy (P < 0.05). The frequency of the allele A was higher in patients with macroangiopathy than in patients without macroangiopathy (25.6 vs. 16.3%; P < 0.05). Moreover, the plasma leptin levels were markedly higher in patients with AA genotype than those with AG or GG genotype in patients with macroangiopathy (P < 0.05). The LEPR 223A>G gene polymorphism associated with a predisposition to increased plasma leptin levels could constitute a useful predictive marker for diabetic macroangiopathy.     

2 型糖尿病患者肝损伤标志物与下肢动脉病变的相关性分析

目的：探讨2 型糖尿病患者肝损伤标志物水平与其下肢动脉病变的相关性,为2 型糖尿病并发症的防治提供参考依据。方 法：选取我院收治的2 型糖尿病患者946 例,根据下肢动脉内膜中层厚度分为以下3 组,即无动脉硬化组(276 例)、单纯性动脉硬 化组(598 例)和动脉硬化伴管腔狭窄或闭塞组(72 例)。分析和比较三组之间肝损伤标志物谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(GGT)水平的差异,及其与2型糖尿病患者下肢动脉硬化程度的相关性。结果：随着动脉硬化程度的加重,2 型糖尿病患者的ALT 水平逐渐升高,三组之间两两比较差异均有统计学意义(P<0.05)。动脉硬化伴管腔狭窄或闭塞组AST 水平显著高于非动脉硬化组和单纯性下肢动脉硬化组,而动脉硬化组和非动脉硬化组之间AST 水平比较无显著差异(P>0.05)。三组之间γ-谷氨酰转肽酶水平比较无显著性差异(P>0.05)。Spearman 等级相关分析显示ALT 与糖尿病下肢动脉硬化的相关系数为0.30484。结论：2型糖尿病患者ALT 水平与其下肢动脉硬化程度显著相关。     

急性脑梗死合并脑白质疏松症患者血清CP、MBP、MCP-1与病情严重程度和预后的关系

摘要 目的：探究急性脑梗死（ACI）合并脑白质疏松症（LA）患者血清C肽（CP）、髓鞘碱性蛋白（MBP）、单核细胞趋化蛋白-1（MCP-1）水平与病情严重程度和预后关系。方法：选取南京鼓楼医院集团宿迁医院于2021年3月至2023年3月期间收治的ACI合并LA患者117例作为观察组,根据根据LA严重程度分为重度组39例、中度组40例和轻度组38例。另选取同期体检健康人120例纳入对照组。检测血清CP、MBP、MCP-1水平。对ACI合并LA患者行6个月的随访。多因素Logistic回归分析ACI合并LA患者预后不良的影响因素。受试者特征曲线（ROC）分析血清CP、MBP和MCP-1对ACI合并LA患者预后的预测价值。结果：与对照组相比,观察组MBP、MCP-1更高,CP更低（P<0.05）。重度组血清CP显著低于轻度组和中度组,MBP、MCP-1水平显著高于轻度组和中度组;中度组血清CP显著低于轻度组,MBP、MCP-1水平显著高于轻度组（均P<0.05）。与预后良好组相比,预后不良组CP更低,MBP、MCP-1更高（P<0.05）。多因素Logistic回归分析显示NIHSS评分升高、MBP升高、MCP-1升高是ACI合并LA患者预后不良的独立危险因素,CP升高是保护因素（P<0.05）。ROC分析结果显示CP、MBP和MCP-1联合预测ACI合并LA患者预后不良的曲线下面积（AUC）为0.916,高于CP、MBP和MCP-1单独预测。结论：ACI合并LA患者血清CP较健康群体更低,血清MBP、MCP-1水平较健康群体更高,且CP、MBP和MCP-1与患者病情程度存在密切联系。血清CP、MBP和MCP-1联合检测对ACI合并LA患者预后有较高预测价值。     

Genetic polymorphism c.1562C>T of the MMP-9 is associated with macroangiopathy in type 2 diabetes mellitus

Objective

To determine whether the matrix metalloproteinase-9 (MMP-9) c.1562C>T polymorphism has an effect on the plasma MMP-9 levels and the macroangiopathic complications in type 2 diabetes mellitus (T2DM).

Methods

The genotypes and allelic frequencies of the MMP-9 c.1562C>T were examined with polymerase chain reaction and restriction fragment length polymorphism in 320 patients with T2DM and 160 unrelated healthy subjects. The plasma concentrations of MMP-9 were determined in all subjects.

Results

The mean plasma concentrations of MMP-9 of patients with T2DM were significantly higher than that of controls and the plasma levels of MMP-9 were higher in diabetic patients with macroangiopathy than in patients without macroangiopathy (P < 0.05). The genotype (CC, CT, and TT) distribution of c.1562C>T polymorphism of the MMP-9 gene was 60.0%, 31.3%, and 8.8% in diabetic patients with macroangiopathy, 76.3%, 21.3%, and 2.5% in patients without macroangiopathy, and 77.5%, 21.3%, 1.3% in controls, respectively, a significant difference was found between diabetic patients with and without macroangiopathy (P < 0.05). The frequency of the allele T was higher in patients with macroangiopathy than in patients without macroangiopathy (24.4% vs 13.1%; P < 0.05). Moreover, the plasma MMP-9 levels were markedly higher in patients with TT genotype than those with CC or CT genotype in patients with macroangiopathy (P < 0.05).

Conclusion

The MMP-9 c.1562C>T gene polymorphism associated with a predisposition to increased plasma MMP-9 levels could constitute a useful predictive marker for diabetic macroangiopathy.     

Serum levels of type III procollagen peptide in diabetes mellitus

Serum levels of type III procollagen peptide (P-III-P) were investigated in 19 patients with type 1 (insulin-dependent) and in 48 (25 orally treated, 23 insulinized) patients with type 2 (non insulin-dependent) diabetes mellitus. Among patients with type 2 diabetes, 16 orally treated and 14 insulin-treated subjects had macrovascular complications. P-III-P levels were not correlated with the duration of diabetes and with glucose control, nor were there any significant sex and age differences in the levels. P-III-P values were significantly higher in the sera of insulin-treated non insulin-dependent diabetic patients with macroangiopathy. These high values (18.5 +/- 10.8 ng/ml) were in contrast with normal values in healthy subjects (8.5 +/- 2.5, P less than 0.001), insulin-dependent diabetics (9.9 +/- 3.4 ng/ml, P less than 0.01), non insulin-dependent diabetics treated with oral agents (8.2 +/- 2.6 ng/ml, P less than 0.001) and insulin-treated non insulin-dependent patients without macroangiopathy (8.2 +/- 4.9 ng/ml, P less than 0.001). Although this study does not demonstrate that an increase in type III collagen synthesis is responsible for the pathogenesis of macroangiopathy, it suggests that insulin-dependent fibroblast sensitization may play a role in the acceleration and progression of macroangiopathy.     

定坤丹联合复宫宁颗粒治疗子宫内膜异位症的疗效及对血清MCP-1、sICAM-1、CA125水平的影响

目的:探讨定坤丹联合复宫宁颗粒治疗子宫内膜异位症的疗效及对血清单核细胞趋化蛋白-1(MCP-1)、可溶性细胞间粘附分子(s ICAM-1)、CA125水平的影响。方法:选择2014年12月至2016年12月我院接诊的96例子宫内膜异位症患者,通过随机数表法将其分为观察组(n=48)和对照组(n=48)。对照组给予醋酸亮丙瑞林微球注射液联合定坤丹治疗,观察组在对照组基础上联合复宫宁颗粒治疗,两组均连续治疗3个疗程。比较两组治疗前后卵泡生成激素(FSH)、黄体生成激素(LH)、雌二醇(E2)及血清MCP-1、s ICAM-1、CA125水平的变化,临床疗效及不良反应的发生情况。结果:治疗后,观察组临床疗效总有效率明显高于对照组(93.75%vs.70.83%,P<0.05),FSH、LH明显低于对照组,E2明显高于对照组(P<0.05);两组血清MCP-1、s ICAM-1、CA125较治疗前均显著降低(P<0.05),观察组以上指标明显低于对照组(P<0.05)。此外,观察组潮热、多汗、阴道出血总发生率明显低于对照组(P<0.05)。结论:与醋酸亮丙瑞林微球注射液联合定坤丹治疗相比,定坤丹联合复宫宁颗粒治疗子宫内膜异位症的效果更好,其可有效改善患者卵巢内分泌功能,缓解临床症状,其内在机制可能和降低血清MCP-1、s ICAM-1、CA125水平相关。     

Primary structures of MCP-1 and MCP-2, natural peptide antibiotics of rabbit lung macrophages

The microbicidal peptides, MCP-1 and MCP-2, of rabbit alveolar macrophages were purified by an improved procedure that employed preparative gel electrophoresis and high performance liquid chromatography. The peptides were arginine- and cystine-rich and lacked free sulfhydryl groups and detectable levels of carbohydrate. Complete sequence determinations revealed that MCP-1 differed from MCP-2 only by the substitution of arginine for leucine at residue 13 from the NH2 terminus and that the molecules were each single chain polypeptides of 33 amino acid residues containing three intramolecular disulfide bonds. The complete amino acid sequences of MCP-1 and MCP-2 are: (sequence in text)     

Study of 27 Aqueous Humor Cytokines in Type 2 Diabetic Patients with or without Macular Edema

The aim of the present study was to compare the changes in the levels of 27 aqueous humor cytokines between diabetic patients with macular edema (ME) and diabetic patients without ME. Undiluted aqueous humor samples were obtained from 68 consecutive type 2 diabetic patients without ME and 56 consecutive type 2 diabetic patients with ME. The concentrations of 27 cytokines in the aqueous humor samples were measured using a multiplex bead immunoassay. Compared with diabetic patients without ME, diabetic patients with ME had significantly higher concentrations of IL-1β, IL-6, IL-8, IP-10, MCP-1, and VEGF in the aqueous humor. However, the concentrations of IL-10 and IL-12 were significantly lower in the diabetic patients with ME. The aqueous humor levels of IL-1β, IL-6, IL-8, MCP-1, IP-10, and VEGF were closely correlated with retinal macular thickness, retinal macular volume and the severity of ME. In addition, the aqueous humor levels of IL-10 and IL-12 decreased with increasing the severity of ME. A variety of cytokines associated with inflammation and angiogenesis may contribute to the pathogenesis of diabetic macular edema, and both anti-inflammatory and antiangiogenic agents should be included in the treatment of ME simultaneously.