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目的探讨2型糖尿病(T2DM)患者中性粒细胞明胶酶相关载脂蛋白(NGAL)和颈动脉粥样硬化的关系。方法选取2型糖尿病患者120例为病例组(其中T2DM不合并肾病58例,T2DM合并早期肾病62例),体检健康者60例为对照组,比较各组一般资料、颈动脉内中膜厚度(IMT)值、血清NGAL和超敏C反应蛋白(hs-CRP)水平;比较不同IMT水平T2DM患者NGAL水平差异的差异;采用Spearman相关分析各指标之间的关系,采用Logistic回归分析T2DM合并CAS的危险因素。结果 T2DM组颈动脉粥样硬化发生率、IMT值均明显高于对照组;T2DM合并早期肾病组血清NGAL、hs-CRP水平、IMT值和CAS发生率均明显高于T2DM未合并肾病组;斑块组和内膜增厚组血清NGAL和hs-CRP明显高于正常组。Spearman相关分析显示,血清NGAL水平与IMT值呈正相关(r=0.315,P<0.05);Logistic回归分析显示,血清NGAL水平升高为T2DM患者发生动脉粥样硬化的危险因素(OR=2.84,P<0.05)。结论 2型糖尿病患者的NGAL水平和颈动脉粥样硬化发生率随着糖尿病肾病的发生而增高,血清NGAL水平升高可能促进T2DM患者发生颈动脉粥样硬化。
Objective To investigate the relationship between neutrophil gelatinase-associated apolipoprotein (NGAL) and carotid atherosclerosis in type 2 diabetes mellitus (T2DM). Methods Totally 120 patients with type 2 diabetes were selected as the case group (58 with T2DM without nephropathy and 62 with T2DM with early nephropathy), and 60 with healthy subjects as control group. The carotid intima-media thickness (IMT), serum NGAL and hs-CRP. The differences of NGAL levels in different IMT patients with T2DM were compared. Spearman correlation analysis was used to analyze the relationship between the indexes. Logistic regression analysis was used to analyze the association between T2DM and CAS Risk factors. Results The incidence of carotid atherosclerosis and IMT in T2DM group were significantly higher than those in control group. The levels of serum NGAL, hs-CRP, IMT and CAS in T2DM with early nephropathy were significantly higher than those without T2DM The levels of serum NGAL and hs-CRP in block group and intimal thickening group were significantly higher than those in normal group. Spearman correlation analysis showed that there was a positive correlation between serum NGAL level and IMT (r = 0.315, P <0.05). Logistic regression analysis showed that elevated serum NGAL level was the risk factor for atherosclerosis in T2DM patients (OR = 2.84, P <0.05). Conclusions The level of NGAL and carotid atherosclerosis in patients with type 2 diabetes mellitus (DM) are increased with the development of diabetic nephropathy. Increased serum NGAL levels may promote carotid atherosclerosis in T2DM patients.