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2型糖尿病合并血脂异常患者血浆内皮素-1和血管性血友病因子水平升高。

Increased plasma levels of endothelin 1 and von Willebrand factor in patients with type 2 diabetes and dyslipidemia.

作者信息

Seligman B G, Biolo A, Polanczyk C A, Gross J L, Clausell N

机构信息

Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil.

出版信息

Diabetes Care. 2000 Sep;23(9):1395-400. doi: 10.2337/diacare.23.9.1395.

Abstract

OBJECTIVE

Endothelial markers endothelin 1 (ET-1) and von Willebrand factor (vWF) were assessed in patients with type 2 diabetes and dyslipidemia and in patients with hypercholesterolemia.

RESEARCH DESIGN AND METHODS

In this case-control study, plasma ET-and vWF levels were measured by enzyme-linked immunosorbent assay in 35 normoalbuminuric type 2 diabetic patients with dyslipidemia (56+/-5 years), in 21 nondiabetic patients with hypercholesterolemia (52+/-7 years), and in 19 healthy control subjects (45+/-4 years). All of the individuals were normotensive and nonsmokers. Urinary albumin was measured by immunoturbidimetry.

RESULTS

ET-1 levels were higher (P<0.0001) in type 2 diabetic dyslipidemic patients (1.62+/-0.73 pg/ml) than in both nondiabetic hypercholesterolemic patients (0.91+/-0.73 pg/ml) and control subjects (0.69+/-0.25 pg/ml). vWF levels were significantly increased (P = 0.02) in type 2 diabetic (185.49+/-72.1%) and hypercholesterolemic (163.29+/-50.7%) patients compared with control subjects (129.70+/-35.2%). In the multiple linear regression analysis. ET-1 was significantly associated (adjusted r2 = 0.42) with serum triglyceride levels (P<0.001), age (P<0.01), insulin sensitivity index (P<0.02), and albuminuria levels (P<0.04). vWF levels were associated (adjusted r2 = 0.22) with albuminuria (P<0.001), fibrinogen levels (P<0.02), and BMI (P<0.03).

CONCLUSIONS

Compared with hypercholesterolemic patients, type 2 diabetic patients with dyslipidemia have increased levels of ET-1 and vWF which may indicate more pronounced endothelial injury. These findings appear to be related to components of the insulin resistance syndrome.

摘要

目的

评估2型糖尿病合并血脂异常患者及高胆固醇血症患者的内皮标志物内皮素1(ET-1)和血管性血友病因子(vWF)。

研究设计与方法

在这项病例对照研究中,采用酶联免疫吸附测定法测量了35例正常白蛋白尿的2型糖尿病合并血脂异常患者(56±5岁)、21例非糖尿病高胆固醇血症患者(52±7岁)和19例健康对照者(45±4岁)的血浆ET-1和vWF水平。所有个体血压正常且不吸烟。采用免疫比浊法测量尿白蛋白。

结果

2型糖尿病合并血脂异常患者的ET-1水平(1.62±0.73 pg/ml)高于非糖尿病高胆固醇血症患者(0.91±0.73 pg/ml)和对照者(0.69±0.25 pg/ml)(P<0.0001)。与对照者(129.70±35.2%)相比,2型糖尿病患者(185.49±72.1%)和高胆固醇血症患者(163.29±50.7%)的vWF水平显著升高(P = 0.02)。在多元线性回归分析中,ET-1与血清甘油三酯水平(P<0.001)、年龄(P<0.01)、胰岛素敏感性指数(P<0.02)和白蛋白尿水平(P<0.04)显著相关(调整后r2 = 0.42)。vWF水平与白蛋白尿(P<0.001)、纤维蛋白原水平(P<0.02)和体重指数(P<0.03)相关(调整后r2 = 0.22)。

结论

与高胆固醇血症患者相比,2型糖尿病合并血脂异常患者的ET-1和vWF水平升高,这可能表明内皮损伤更明显。这些发现似乎与胰岛素抵抗综合征的组成部分有关。

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