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目的探讨2型糖尿病(T2DM)血清淀粉样蛋白A(SAA)浓度与2型糖尿病患者颈动脉内膜-中膜复合体厚度(IMT)的关系。方法2005年1月至7月对郑州大学第一附属医院的20名健康体检者和69例2型糖尿病病人采用高敏感B型超声测定颈动脉IMT,并用酶联免疫吸附法(ELISA)测定每个受试者的血清SAA质量浓度。结果T2DM组较正常对照组血清SAA明显升高[3·08(2·1~5·06)mg/L与1·37(1·07~1·86)mg/L,P<0·01]。单因素相关分析结果显示SAA与IMT值、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TC)、空腹血糖(FPG)分别呈正相关,P<0·01。糖尿病组患者的颈动脉IMT值与对照组比较,差异有显著性意义[(0·98±0·23)mm与(0·73±0·19)mm,P<0·01]。在IMT与基本生化指标及血清SAA之间的多组分析显示年龄、SAA和降低的HDL-C与IMT的升高有独立的相关性,且危险系数年龄>SAA>降低的HDL。结论SAA和颈动脉IMT密切相关,提示SAA和2型糖尿病的大血管病变有关,也是亚临床期动脉粥样硬化的一项危险因素。
Objective To investigate the relationship between serum amyloid A (SAA) level in type 2 diabetes mellitus (T2DM) and carotid intima - media thickness (IMT) in type 2 diabetic patients. Methods From January 2005 to July 2005, 20 healthy subjects and 69 patients with type 2 diabetes mellitus in the First Affiliated Hospital of Zhengzhou University were enrolled in this study. The carotid artery IMT was measured by high sensitive B - mode ultrasound and the expression of IMT was measured by enzyme linked immunosorbent assay (ELISA) Serum SAA mass concentration of subjects. Results Serum SAA in T2DM group was significantly higher than that in control group [3.08 (21.56) mg / L vs 1.37 (1.07-1.86) mg / L, P <0.01 ]. The results of univariate analysis showed that there was a positive correlation between SAA, IMT, LDL-C, FP and FPG (P <0.01). The carotid IMT in patients with diabetes mellitus was significantly lower than that in the control group [(0.98 ± 0.23) mm vs (0.73 ± 0.19) mm, P <0.01]. Multiple sets of analyzes between IMT and essential biochemical markers and serum SAA showed that age, SAA, and decreased HDL-C were independently associated with elevated IMT, and HDL with a hazard ratio of> SAA> decreased. Conclusions SAA and carotid IMT are closely related, suggesting that SAA is associated with macroangiopathy in type 2 diabetes and is also a risk factor for subclinical atherosclerosis.