摘要
目的探讨血清基质金属蛋白酶2(MMP-2)、金属蛋白酶2组织抑制剂(TIMP-2)及超敏C反应蛋白(hs-CRP)与2型糖尿病(T2DM)患者大血管病变的关系。方法选取2010年9月—2011年4月在我科住院的T2DM患者60例,根据颈动脉内膜中层厚度(CIMT)将患者分为无CIMT增厚组(CIMT≤0.9 mm)和CIMT增厚组(CIMT>0.9 mm),各30例。另选取同期在本院体检中心体检的健康者30例为对照组。采用酶联免疫吸附法测定3组受检者血清MMP-2、TIMP-2水平,采用全自动生化分析仪测定血清hs-CRP水平,比较3组受检者这3个指标的差异,并将这3个指标与临床及生化指标进行Pearson相关分析和多元逐步线性回归分析。结果 (1)对照组、无CIMT增厚组、CIMT增厚组血清MMP-2〔分别为(547±130)、(986±104)和(1 346±204)μg/L〕、TIMP-2〔分别为(67.3±9.4)、(87.2±6.5)和(102.6±14.5)μg/L〕、hs-CRP水平〔分别为(0.92±0.28)、(2.72±1.12)、(4.29±2.59)mg/L〕比较,差异均有统计学意义(P<0.01),且组间两两比较差异亦有统计学意义(P<0.05)。(2)相关分析显示,血清MMP-2、TIMP-2及hs-CRP均与收缩压、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)呈正相关(P<0.05),与高密度脂蛋白胆固醇(HDL-C)呈负相关(P<0.01);此外,血清MMP-2还与三酰甘油(TG)、空腹血糖(FPG)、TIMP-2、hs-CRP呈正相关(P<0.05),血清TIMP-2还与舒张压、TG、hs-CRP呈正相关(P<0.05),hs-CRP还与FPG呈正相关(P<0.01)。回归分析显示,TIMP-2、hs-CRP是影响MMP-2的主要因素(标准化偏回归系数分别为0.829和0.166,P均<0.05);MMP-2、舒张压是影响TIMP-2的主要因素(标准化偏回归系数分别为0.904和0.147,P均<0.05);MMP-2、收缩压是影响hs-CRP的主要因素(标准化偏回归系数分别为0.488和0.317,P均<0.05)。结论 T2DM患者血清MMP-2、TIMP-2、hs-CRP水平较健康者显著升高,尤其是T2DM合并大血管病变的患者;MMP-2和TIMP-2可能与炎症密切相关;检测血清MMP-2、TIMP-2及hs-CRP水平,对监测T2DM大血管病变的发生、发展有重要的临床意义。
Objective To investigate the association between the levels of serum MMP - 2, TIMP - 2, hs - CRP and macroangiopathy of patients with type 2 diabetes mellitus （T2DM） . Methods According to CIMT, 60 T2DM patients admitted to our department from September 2010 to April 2011 were divided into CIMT non - thickening group （ CIMT≤0. 9 mm） and CIMT thickening group （CIMT 〉0. 9 mm） with each group 30 cases. 30 healthy people who underwent physical examination in our hospital were involved as control group. ELISA method was used to detect the serum MMP -2 and TIMP -2, and automatic biochemical analyzer was used to detect the serum hs - CRP in the three groups. The three indicators were compared among the three groups, and Pearson correlation analysis and multiple linear regression analysis were conducted for the three indicators, clinical and biochemical indicators. Results （ 1 ） Among the three groups, serum MMP - 2 [（547±130）, （986±104） and （1346±204） μg/L3, TIMP-2 [ （67.3 ±9.4）, （87.2±6.5） and （102.6±14.5）μg/L3 and hs-CRP [ （0.92±0. 28 ）, （ 2. 72±1.12 ） and （4. 29± 2. 59 ） mg/L ]showed statistically significant differences （ P 〈 0. 01 ）, and pairwise comparison also showed statistically significant differenees （ P 〈 0. 05 ） . （2） Correlation analysis showed that serum MMP - 2, TIMP - 2 and hs - CRP were all positively correlated with systolic pressure, TC, LDL - C and HbAlc （ P 〈 0. 05 ） , but were negatively correlated with HDL- C （P 〈0. 01 ） . Besides, serum MMP -2 was positively correlated with TG, FPG, TIMP -2 and hs - CRP （ P 〈 0. 05 ）, serum TIMP - 2 was positively correlated with diastolie pressure, TG and hs - CRP （ P 〈 0.05 ）, hs - CRP was positively correlated with FPG （ P 〈 O. O1 ） . Regression analysis showed that TIMP - 2 and hs - CRP were the ma- jor factors influeneing the MMP - 2 （ standardized regression coeffieient was 0. 829 and 0. 166 respeetively, Pboth 〈 0. 05 ） . MMP - 2 and diastolic pressure were the major factors influeneing the TIMP - 2 （ standardized regression coefficient was 0. 904 and 0. 147 respectively, Pboth 〈 0. 05 ） . MMP - 2 and systolic pressure were the major factors influencing the hs - CRP （ stand- ardized regression eoeffieient was O. 488 and 0. 317 respeetively, Pboth 〈 0. 05 ） . Conclusion The levels of serum MMP - 2, TIMP-2 and hs - CRP in T2DM patients, especially those combined with macroangiopathy, were significantly higher than healthy people. MMP - 2 and TIMP - 2 may be elosely related to inflammation. The detection of serum MMP - 2, TIMP - 2 and hs - CRP is of great signifieanee for the surveillance of the oeeurrenee and development of maeroangiopathy in T2DM.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第9期991-994,共4页
Chinese General Practice
基金
广西科学研究与技术开发计划项目(桂科攻11138007)
关键词
基质金属蛋白酶2
金属蛋白酶2组织抑制剂
超敏C反应蛋白
糖尿病
2型
糖尿病血管病变
Matrix metalloproteinase 2
Tissue inhibitor of metalloproteinase - 2
Hypersensitive C - reaetive pro-tein
Diabetes mellitus, type 2
Diabetic angiopathies
