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目的探讨1型糖尿病(T1DM)患者胰岛素治疗前后血浆护骨素(OPG)水平的变化。方法选择22例新诊断的1型 DM 患者和28例健康个体。T1DM 患者采用胰岛素治疗6个月。血浆 OPG 采用 ELISA 法测定。采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能和硝酸甘油(GTN)介导的内皮非依赖性血管舒张功能。结果 T1DM 患者治疗前血浆 OPG 水平为3.09 ng/L±0.70 ng/L,明显高于对照组(2.07ng/L±0.75 ng/L,P<0.01)。治疗6个月后血浆OPG 水平明显降低(2.58 ng/L±0.59 ng/L,P<0.01)。T1DM 患者治疗前内皮依赖性血管舒张功能(3.35%±0.67%)明显低于对照组(5.17%±0.83%,P<0.01)。治疗6个月后有明显改善(4.27%±0.63%,P<0.01)。多元相关分析显示,治疗前血浆 OPG 与内皮依赖性血管舒张功能,空腹血糖(FPG),糖化血红蛋白(HbA1c),超敏 C 反应蛋白(CRP)相关(均 P<0.01)。治疗前后 OPG的变化与内皮依赖性血管舒张功能,FPG、HbA1c、CRP 的变化相关(均 P<0.01)。结论新诊断的T1DM 患者血浆 OPG 水平明显增高,血浆 OPG 与血管内皮功能相关。
Objective To investigate the changes of plasma osteoprotegerin (OPG) levels in patients with type 1 diabetes (T1DM) before and after insulin therapy. Methods Twenty-two newly diagnosed type 1 DM patients and 28 healthy individuals were selected. T1DM patients treated with insulin for 6 months. Plasma OPG was measured by ELISA. Brachial artery-mediated endothelium-dependent vasodilatation and nitroglycerin (GTN) -mediated endothelium-independent vasodilation were measured by high resolution extracorporeal ultrasonography. Results The level of plasma OPG in patients with T1DM before treatment was 3.09 ng / L ± 0.70 ng / L, which was significantly higher than that of the control group (2.07 ng / L ± 0.75 ng / L, P <0.01). After 6 months of treatment, the plasma OPG level was significantly lower (2.58 ng / L ± 0.59 ng / L, P <0.01). Endothelium-dependent vasodilation (3.35% ± 0.67%) in T1DM patients before treatment was significantly lower than that in controls (5.17% ± 0.83%, P <0.01). After 6 months of treatment, there was a significant improvement (4.27% ± 0.63%, P <0.01). Multivariate correlation analysis showed that pretreatment plasma OPG was associated with endothelium-dependent vasodilation, fasting plasma glucose (FPG), HbA1c, and CRP (all P <0.01). Changes of OPG before and after treatment were correlated with changes of endothelium-dependent vasodilation, FPG, HbA1c and CRP (all P <0.01). Conclusion The newly diagnosed T1DM patients with elevated plasma levels of OPG, plasma OPG and vascular endothelial function.