冠心病合并2型糖尿病血清视黄醇结合蛋白4水平与冠状动脉病变程度的相关性研究

【】　目的　研究合并2型糖尿病的冠心病患者冠状动脉病变程度与血清视黄醇结合蛋白4（retinol-bindingprotein4，RBP4）水平的相关性。　方法　2008年10月-2010年4月选择性冠状动脉造影确诊的冠心病患者共120例，分为单纯冠心病组（A组）60例和冠心病合并糖尿病组（B组）60例，检测血糖、血脂、胰岛素以及脂联素、RBP4水平；根据冠状动脉造影结果，以Gensini评分评判冠状动脉病变程度。　结果　B组空腹血糖、胰岛素、RBP4均显著高于A组（P<0.05）；冠状动脉病变程度更重（P<0.05）。相关性分析显示RBP4水平与低密度脂蛋白胆固醇、胰岛素抵抗和冠状动脉病变积分呈正相关（r=0.312、0.322、0.314，P<0.05）。与脂联素水平呈负相关（r=-0.362，P<0.01）。　结论　冠心病合并2型糖尿病患者RBP4明显升高，且与冠状动脉狭窄程度呈正相关。【Abstract】　Objective　Toexploretherelationshipbetweenthelevelofserumretinol-bindingprotein4(RBP4)andtheextentofcoronarylesionsincoronaryheartdisease(CHD)patientsaccompaniedwithtype2diabetesmellitus(T2DM).　Methods　Atotalof120patientswithCHDdiagnosedbycoronaryarteriongraphybetweenOctober2008andApril2010wereenrolled.ThepatientsweredividedintotwogroupsCHDgroup(60patients);CHDaccompaniedwithT2DMgroup(60patients).Thelevelsofseruminsulin,adiponectinandRBP4weremeasured.AllthepatientsunderwentcoronaryangiographyandtheextentofcoronarylesionswasassessedquantitativelybasedontheGensini′sscoringsystem.　Results　Thelevelsofseruminsulin,plasmaRBP4andtheextentofcoronaryarterystenosisinCHDaccompaniedwithT2DMgroupweresignificantlyhigherthanthoseinCHDgroup(P<0.05).CorrelationanalysisshowedthatthelevelofRBP4waspositivelycorrelatedwithLDL-C,insulinresistanceindexandthecoronaryarterynarrowdegree（r=0.312,0.322,0.314;P<0.05);andnegativelycorrelatedwithadiponectin(r=-0.362,P<0.01).　Conclusion　ThesignificantelevatedplasmaRBP4inCHDpatientsaccompaniedwithT2DMispositivelycorrelatedwiththeextentofcoronaryarterylesion.