陈荣浩 王尧

[摘要] 目的 探讨2型糖尿病（T2DM）患者血清Perilipin 1变化与大血管病变的相关性。方法 回顾性分析2016年10月—2017年11月就诊于丹阳人民医院内分泌科的T2DM患者268例，根据有无大血管并发症分为合并大血管病变组（A组，168例）和单纯T2DM组（B组，100例），另选取同期来该院进行体检的健康人员作为对照组（C组，50名）。检测各组血清Perilipin 1水平，并测定空腹血糖（FBG）、餐后2 h血糖（2 hPBG）、糖化血红蛋白（HbA1c）及其他生化指标；采用超声检查所有T2DM患者的颈动脉内膜中层厚度（IMT）。 结果 A组和B组患者血清Perilipin 1水平明显高于C组（P<0.01），A组患者血清Perilipin 1水平高于B组（P<0.05）。血清Perilipin 1水平与年龄、HbA1c、FBG、LDL-C呈正相关，与HDL-C呈负相关。Logistic回归分析显示，血清Perilipin 1是T2DM大血管病变的危险因素。结论 血清Perilipin 1水平是T2DM患者大血管病变的独立危险因素之一，与大血管病变的发生发展密切相关。

[关键词] 血清Perilipin 1；2型糖尿病；大血管病变；颈动脉内膜中层厚度

[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2018）03（b）-0021-03

Research on Correlation between Serum Perilipin 1 Level and Macroangiopathy of Patients with Type 2 Diabetes

CHEN Rong-hao1， WANG Yao2

1.Department of Endocrinology， Danyang Peoples Hospital， Danyang， Jiangsu Province， 212300 China；2.Department of Endocrinology， Zhongda Hospital Affiliated to Southeast University， Nanjing， Jiangsu Province， 210009 China

[Abstract] Objective To study the correlation between serum Perilipin 1 level and macroangiopathy of patients with type 2 diabetes. Methods 268 cases of T2DM patients diagnosed in our hospital from October 2016 to November 2017 were selected and divided into the two groups respectively 168 cases and 100 cases in each， the group A were the patients with T2DM combined with macroangiopathy， and the group B were the patients with simple T2DM， and the control group were 50 cases of healthy staff for physical examination in our hospital （the group C）， and the serum Perilipin 1 level of each group was tested， and the FBG， 2hPBG and HbA1c and other biochemical indexes were measured， and the IMT of all patients was tested by the ultrasound examination. Results The serum Perilipin 1 level in the group A and in the group B were obviously higher than that in the group C（P<0.01）， and the serum Perilipin 1 level in the group A was higher than that in the group B（P<0.05）， and the serum Perilipin 1 level was positively correlated with the age， HbA1c， FBG， LDL-C and was negatively correlated with HDL-C， and the Logistic regression analysis showed that the serum Perilipin 1 was the risk factors of T2DM macroangiopathy. Conclusion The serum Perilipin 1 level is an independent risk factor of patients with T2DM macroangiopathy， closely related to the occurrence and development of macroangiopathy.

[Key words]Serum Perilipin 1； Type 2 diabetes； Macroangiopathy； IMT

2型糖尿病（type 2 diabetes mellitus，T2DM）大血管病變是糖尿病患者死亡的主要病因[1]，其病理表现主要是大血管壁内中膜增厚，动脉斑块形成[2]。脂滴包被蛋白（Perilipin）是特异表达于脂肪细胞和类固醇生成细胞脂滴表面的一种磷蛋白，对脂肪的代谢调节具有重要作用[3-4]。有研究数据表明，Perilipin A基因参与动脉粥样硬化斑块的形成，Langlois等[5]发现，Perilipin 1基因敲除小鼠在代谢指标正常的情况下，出现了动脉粥样硬化的风险明显增加。虽然Perilipin基因在心血管领域的研究比较深入，但是Perilipin 1在T2DM合并大血管病变人群中的研究较少。该研究选取2016年10月—2017年11月收治的268例患者为研究对象旨在探讨2型糖尿病（T2DM）患者血清Perilipin 1变化与大血管病变的相关性，从而探究出Perilipin 1在T2DM合并大血管病变发生发展的作用，现报道如下。

1 资料与方法

1.1 一般资料

选取就诊于丹阳人民医院内分泌科的T2DM患者268例，所有患者均符合1999年WHO制定的T2DM诊断标准；……