黄东辉 郭征东 唐先格 孙田歌

　　作者单位：271000山东泰安，泰山医学院临床学院(黄东辉);泰山医学院附属医院内分泌科(郭征东、唐先格、孙田歌)

　　【摘要】目的 研究2型糖尿病(T2DM)患者不同程度的下肢血管病变与血浆内脏脂肪素的关系。 方法 选择泰安地区的T2DM患者112例，根据临床症状和下肢动脉彩色多普勒超声情况，分为单纯T2DM组42例，糖尿病合并轻度下肢动脉硬化(T2DM-MLAD)组38例和糖尿病合并重度下肢动脉硬化(T2DM-SLAD)组32例，另选取正常对照(NC)组40名。测定内脏脂肪素和其他相关临床指标，进行数据统计。结果NC组与单纯T2DM组相比内脏脂肪素无统计学差异[分别(46.79±7.67)和(50.86±11.65) ng/ml，P>0.05]，T2DM-MLAD组和T2DM-SLAD组内脏脂肪素[分别(58.75±13.52)和(67.21±16.6) ng/ml]均明显高于NC组和单纯T2DM组(P<0.01)，T2DM-SLAD组又明显高于T2DM-MLAD组 (P<0.01)。Pearson相关分析表明，内脏脂肪素与WHR、FIns、HOMA-IR、下肢血管内膜中层厚度(IMT)、HbA1c呈正相关。踝肱指数(ABI)随糖尿病下肢动脉病变的出现与加重而逐渐降低。结论内脏脂肪素与T2DM患者下肢血管病变程度明显相关，是下肢动脉硬化的危险因素。

　　【关键词】糖尿病，2型;下肢血管病变;内脏脂肪素;内膜中层厚度，下肢动脉

　　doi:10.3969/j.issn.1006-6187.2011.02.008

　　A relationship between lower limb vascular disease and plasma visfatin in patients with T2DM

　　HUANG Dong-hui，GUO Zheng-dong，TANG Xian-ge，et al. Clinical College of Taishan Medical University，Shandong Taian 271000, China

　　【Abstract】Objective　　To study the relationship of the lowerlimb vascular disease with plasma visfatin in diabetics.MethodsThe study subjects included T2DM patients with mild lower limb atherosclerosis (n=38,T2DM-MLAD), with severe LA (n=32,T2DM-SLAD), without LA (n=42,T2DM) and healthy control (n=40,NC).ABI, serum visfatin,IMT of lower limbs by ultrosound and general clinical data were determined.

　　Results　　Serum visfatin showed a similar level [(46.79±7.67)vs(50.86±11.65)ng/ml, P>0.05] between NC and T2DM groups,and a gradually lower levels from T2DM-SLAD to T2DM-MLAD to T2DM groups[(67.21±16.67)vs(58.75±13.52)vs(50.86±11.65)ng/ml respectively, intergroup comparison: all<0.05]. Serum visfatin was positively correlated with IMT of lower limbs, IR,HbA1c,FIns and WHR.

　　Conclusion Serum visfatin is a risk factor for lower limb atherosclerosis and positively correlated with severity of lower limb atherosclerosis. Ankle-brachial index is decreasing along with the progressing of lower limb atherosclerosis.

　　【Key words】Diabetes mellitus, type 2; Lower limb vascular disease; Visfatin; Intima-media thickness, Lower limbs