摘要: |
目的:分析老年糖尿病性血管病变的可能危险因素,探讨CAⅢ与老年糖尿病性血管病变之间的内在相关性。方法:筛选2017年复旦大学附属华山医院老年病科门诊体检的老年人群,观察糖尿病患者血管并发症的发生情况,以及相关血清生化指标的变化。按照入组标准和排除标准分为三组:对照组,T2DM未合并血管并发症组和T2DM合并血管并发症组。所有老年人群除进行常规体检筛查以外,还需要ELISA法检测血清CAⅢ水平。采用SPSS 25.0统计软件分析数据。结果:与对照组相比,T2DM组的ALT、TP、BUN、UA、TG、LDL、HDL、FBG、HbAlc均存在显著差异(P<0.05)。T2DM组中有血管并发症患者体内的TBIL水平明显低于无血管并发症者(P<0.05)。ELISA检测结果显示T2DM未合并血管并发症和合并血管并发症组患者体内CAⅢ水平均明显低于对照组(P均<0.01),而且T2DM合并血管并发症组CAⅢ水平更低于未合并血管并发症组(P<0.01)。Spearman相关系数分析显示血清CAⅢ水平与HDL和TBIL正相关,但无统计学意义;血清CAⅢ水平与LDL、Scr、BUN、FBG、HbA1c负相关,但与BUN、FBG和HbA1c之间的关联性较大(P<0.05)。ROC曲线分析提示CAⅢ对诊断T2DM合并血管并发症的敏感性和特异性均较好(P<0.05)。结论:血清CAⅢ水平与老年T2DM性糖脂代谢紊乱及其血管并发症密切相关,提示CAⅢ可能是通过调控糖脂代谢等机制来参与老年糖尿病性血管病变的发生和发展进程,但其内在机制尚有待进一步深入研究。 |
关键词: 2型糖尿病 血管并发症 动脉粥样硬化 碳酸酐酶Ⅲ 氧化应激 |
DOI:10.12025/j.issn.1008-6358.2019.20190354 |
分类号:R 587.2 |
基金项目:国家自然科学基金面上项目(81871098, 81571361, 81170322) |
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Clinical Observation Research on the Relationship Between Carbonic Anhydrase Ⅲ and Senile Type 2 Diabetes with Vascular Complications |
YU Zhong-yu1, ZHANG Xiao-ming1, WANG Jian-tao1, WEN Xiao-hong2, XU Xiao-die2, GUO Jing-chun2, ZHOU Hou-guang1
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1.Department of Geriatrics,Huashan Hospital,Fudan University;2.State Key Laboratory of Medical Neurobiology,Institutes of brain science,Shanghai Medical College,Fudan University,Shanghai
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Abstract: |
Objective: To analyze the possible risk factors of senile diabetic angiopathy and explore the intrinsic correlation between CAIII and senile diabetic angiopathy. Methods: Screen the elderly population in the outpatient department of the Geriatrics Department of Huashan Hospital affiliated to Fudan University in 2017. The occurrence of vascular complications in patients with T2DM and the changes of serum biochemical indicators were observed. According to the inclusion criteria and exclusion criteria, they were divided into three groups: control group, T2DM without vascular complication group, T2DM with vascular complication group. In addition to routine physical examination items, the serum CAIII levels were detected by ELISA. Data were analyzed using SPSS 25.0 statistical software. Results: Compared with the control group, there were significant differences in ALT, TP, BUN, UA, TG, LDL, HDL, FBG and HbAlc in the T2DM group (P<0.05). The levels of TBIL in T2DM patients with vascular complications were significantly lower than that in T2DM patients without vascular complications (P<0.05). The results of ELISA showed that the level of CAIII in the T2DM without vascular complication group and T2DM with vascular complication group were significantly lower than that in the control group, while the level of CAIII in the T2DM group with vascular complication was lower than that in the T2DM group without vascular complication (P<0.01). Spearman correlation coefficient analysis showed that serum CAIII levels were positively correlated with HDL and TBIL, but there was no statistical difference; serum CAIII levels were negatively correlated with LDL, BUN, Scr, FBG and HbA1c, and there were statistical difference compared with BUN, FBG and HbA1c (P<0.05). The ROC curve analysis indicated that CAIII was higher accurate in diagnosing T2DM with vascular complication (P<0.05). Conclusion: Serum CAIII was closely related to the disorder of glucose and lipid metabolism,and vascular complications in elderly patients with T2DM, suggesting that CAIII may participate in the occurrence and development of elderly patients with diabetic angiopathy by regulating of glucose and lipid metabolism, but the specific underlying mechanisms need to be further studied in the future. |
Key words: Type 2 diabetes Vascular complications Atherosclerosis Carbonic anhydrase III Oxidative stress. |