2型糖尿病患者血清前蛋白转化酶枯草溶菌素-9水平的变化及其相关性研究

Changes of plasma proprotein convertase subtilisin/kexin type 9 levels in type 2 diabetes mellitus

摘要:

目的：探讨2型糖尿病（type 2 diabetes mellitus，T2DM）中血清前蛋白转化酶枯草溶菌素-9（plasma proprotein convertase subtilisin/kexin type 9，PCSK9）水平变化及其与体质指数（body mass index，BMI）、腰臀比（waist hip ratio，WHR）、空腹血糖（fast－ing blood glucose，FBG）、糖化血红蛋白（glycosylated hemoglobin，HbA1c）水平等的关系。方法：采用酶联免疫法测定了T2DM 54例和正常对照者58例空腹血清PCSK9水平，并分析了血清PCSK9水平与BMI、腰围、臀围、WHR、FBG、HbA1c水平等的关系。结果：①T2DM患者空腹血清PCSK9水平明显高于正常对照组[（260.53±141.70） ng/mL vs.（123.74±73.50） ng/mL，P=0.000]。②相关性研究显示，总人群血清PCSK9水平与BMI、腰围、臀围、WHR、FBG、HbA1c呈正相关（r=0.403，r=0.305，r=0.217，r=0.257，r=0.397，r=0.426，P＜0.05）；女性血清PCSK9水平与BMI、腰围、臀围、WHR、FBG、HbA1c呈正相关（r=0.509，r=0.328，r=0.244，r=0.275，r=0.472，r=0.394，P＜0.05）；男性血清PCSK9水平与腰围、FBG、HbA1c呈正相关（r=0.346，r=0.335，r=0.515，P＜0.05）。③多元逐步回归分析表明总人群中BMI、HbA1c是血清PCSK9水平的独立相关因素；腰围、HbA1c是男性独立相关因素；BMI、FBG是女性独立相关因素。结论：血清PCSK9水平与糖代谢状态有关，可能在T2DM的发生发展中具有一定的作用。

Abstract:

Objective：To investigate the changes of serum plasma proprotein convertase subtilisin/kexin type 9（PCSK9） levels in type 2 diabetes mellitus（T2DM） and to explore its relationship with body mass index（BMI），waist hip ratio（WHR），fasting blood glucose（FBG），glycosylated hemoglobin（HbA1c） as well as other factors. Methods：Fasting serum PCSK9 levels in T2DM（n=54） and normal controls（n=58） were measured by enzyme-linked immunosorbent assay（ELISA）. Relationship between serum PCSK9 levels，and BMI，waist circumference，hip circumference，WHR，FBG，HbA1c were also analyzed. Results：（1）Fasting serum PCSK9 levels in T2DM patients were significantly higher than those in the normal control group[（260.53±141.70） ng/mL vs. （123.74 ± 73.50） ng/mL，P=0.000]. （2）Correlation studies showed that serum PCSK9 levels were positively correlated with BMI，waist circumference，hip cir－cumference，WHR，FBG and HbA1c in the whole study population（r=0.403，r=0.305，r=0.217，r=0.257，r=0.397，r=0.426，P＜0.05），serum PCSK9 levels were positively correlated with BMI，waist circumference，hip circumference，WHR，FBG and HbA1c in the fe－male group（r=0.509，r=0.328，r=0.244，r=0.275，r=0.472，r=0.394，P＜0.05） and positively correlated with waist circumference，FBG and HbA1c in male group（r=0.346，r=0.335，r=0.515，P＜0.05）. （3）Multivariate stepwise regression analysis showed that BMI and HbA1c were independent related factors influencing serum PCSK9 levels in the whole study population. Waist circumference and HbA1c were independent related factors in male group，BMI and FBG were independent related factors in female group. Conclusion：Serum PCSK9 levels are associated with glucose metabolism，and they may contribute，in part，to the pathogenesis of T2DM.