文章摘要
2型糖尿病合并冠心病患者血vaspin IL-6水平与其心功能和胰岛素抵抗的相关性
Correlation of serum vaspin and IL-6 levels with cardiac function and insulin resistance in patients with type 2 diabetes mellitus with coronary heart disease
投稿时间：2018-05-20  
DOI：10.3969/j.issn.1000-0399.2019.03.001
中文关键词: 2型糖尿病  冠心病  内脏脂肪组织丝氨酸蛋白酶抑制因子  白介素-6  胰岛素抵抗  心功能
英文关键词: Type 2 diabetes mellitus  Coronary heart disease  Vaspin  Interleukin-6  Insulin resistance  Cardiac function
基金项目:河南省基础与前沿技术研究计划项目（项目编号：142300410191）
作者单位E-mail
杨琴 454001 河南焦作 河南理工大学第一附属医院(焦作市第二人民医院)心血管内科二区  
王学惠 453100 河南卫辉 新乡医学院第一附属医院心血管内二科 wangxuehui000@126.com 
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中文摘要:
      目的 探讨血清内脏脂肪组织丝氨酸蛋白酶抑制因子（vaspin）、白介素-6（IL-6）与2型糖尿病（T2DM）合并冠心病患者心功能等级及胰岛素抵抗（IR）的关系。方法 选择2014年2月至2017年6月河南理工大学第一附属医院收治的T2DM患者89例，按是否合并冠心病分为T2DM组（n=55）与T2DM合并冠心病组（n=34），并选择30例正常健康人为对照组，均留取外周血标本，采用酶联免疫吸附法测定血清vaspin、IL-6水平，分析上述指标与T2DM合并冠心病患者心功能等级及IR的关系。结果 ①vaspin水平对照组 > T2DM组 > T2DM合并冠心病组，IL-6水平T2DM合并冠心病组 > T2DM组 > 对照组（P<0.05）；②T2DM组与T2DM合并冠心病组空腹血糖（FPG）、餐后2 h血糖（2 h PG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）均高于对照组（P<0.05），T2DM合并冠心病组上述指标高于T2DM组（P<0.05）；③Ⅱ级、Ⅲ级、Ⅳ级T2DM合并冠心病患者vaspin低于Ⅰ级者，IL-6、HOMA-IR高于Ⅰ级者（P<0.05），Ⅲ级、Ⅳ级患者vaspin低于Ⅱ级者，IL-6、HOMA-IR高于Ⅱ级者，Ⅳ级患者vaspin低于Ⅲ级者，IL-6、HOMA-IR高于Ⅲ级者（P<0.05）；④vaspin与T2DM合并冠心病患者心功能等级、HOMA-IR呈负相关，IL-6与其心功能等级、HOMA-IR均呈正相关（P<0.05）。结论 T2DM合并冠心病患者血清vaspin降低、IL-6上升，均可引起胰岛素抵抗，促进冠心病进展。
英文摘要:
      Objective To investigate the relationship between serum visceral adipose tissue serine protease inhibitor(vispin), interleukin-6 (IL-6) and the grade of cardiac function, insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD). Methods 89 patients with T2DM from February 2014 to June 2017 in the First Affiliated Hospital of Henan Polytechnic University were selected and divided into T2DM group (n=55) and T2DM with CHD group (n=34) according to the presence of CHD. 30 normal healthy people were selected as the control group and peripheral blood samples were collected. The levels of vaspin and IL-6 in serum were determined by enzyme-linked immunosorbent assay (ELISA). The relationship between the above indexes and the grade of cardiac function and IR in patients with T2DM complicated with CHD was analyzed. Results ①Arranging from high to low according to the level of vaspin, the order was the control group, T2DM group, T2DM with CHD group, arranging from low to high according to the level of IL-6 the order was the control group, T2DM group, T2DM with CHD group (P<0.05). ②The fasting plasma glucose (FPG), postprandial 2 h plasma glucose (2 h PG), fasting insulin (FINS) and insulin resistance index (HOMA-IR) in the T2DM group and T2DM with CHD group were higher than those in the control group (P<0.05), the above indexes of T2DM combined with CHD group were higher than those of T2DM group (P<0.05). ③The vaspin in patients with grade Ⅱ, Ⅲ, IV T2DM combined with CHD was lower than that in patients with grade I, while IL-6 and HOMA-IR were higher than those in patients with grade I (P<0.05). The vaspin in patients with grade Ⅲ and IV was lower than that in patients with grade Ⅱ, while IL-6 and HOMA-IR were higher than those in patients with grade Ⅱ. The vaspin in patients with grade IV was lower than that in patients with grade Ⅲ, while IL-6 and HOMA-IR were higher than those in patients with grade Ⅲ (P<0.05). ④Vaspin was negatively correlated with cardiac function grade and HOMA-IR in patients with T2DM combined with coronary heart disease, and IL-6 was positively correlated with them (P<0.05). Conclusion In patients with T2DM and coronary heart disease, serum vaspin is decreased and IL-6 is increased, which both can cause insulin resistance and promote the progression of coronary heart disease.
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