Abstract:Objective To investigate the relationship between serum fasting C-peptide (FCP) and vascular disease in patients with type 2 diabetes mellitus (T2DM). Methods A retrospective analysis of 105 patients with T2DM admitted to School Hospital of Nanjing University of Aeronautics & Astronautics from March 2016 to February 2018 was conducted. According to the results of color doppler examination of the lower limbs, the patients were divided into non vascular lesion group (52 cases) and vascular lesion group (53 cases). The general data of the two groups, biochemical indices including fasting blood glucose (FBG), postprandial 2 h blood sugar (PBG), glycated hemoglobin (HbAlc), FCP, postprandial 2 h C-peptide (CP), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were compared between the two groups. Multiple Logistic regression analysis was used to analyze the influencing factors of T2DM patients. Results The age, course and hypertension case number in vascular lesion group was higher than those in non vascular lesion group, and the differences between the two groups were statistically significant (P < 0.05). FBG, PBG, HbAlc and LDL-C in vascular lesion group was significantly higher than those in non vascular lesion group, and the differences were statistically significant (P < 0.05). While FCP, CP and HDL-C were significantly lower than those in non vascular lesion group, and the differences between the two groups were statistically significant (P < 0.05). The results of Logistic regression analysis showed that age (≥50 years), diabetes course (≥5 years), PBG (≥17 mmol/L), HbA1c (≥9%), and LDL-C (≥3 mmol/L) was independent risk factors of vascular lesions in T2DM, and FCP (>0.9 μg/L) and CP (> 2.1 μg/L) was protective factors of vascular lesions (P < 0.05). Conclusion FCP may protect the blood vessels, and the decrease of FCP may be one of the reasons for the occurrence and development of vascular disease in T2DM patients.
[1] Thankappan KR,Sathish T,Tapp RJ,et al. A peer-support lifestyle intervention for preventing type 2 diabetes in India:A cluster-randomized controlled trial of the Kerala Diabetes Prevention Program [J]. PLoS Med,2018,15(6):e1002575.
[2] 关小宏.关于我国糖尿病足防治策略的探讨[J].中华损伤与修复杂志:电子版,2016,11(2):84-89.
[3] 郭哲,常薪霞,夏明锋,等.不同病程2型糖尿病伴脂肪肝患者代谢参数与胰岛功能的相关性分析[J].中国临床医学,2018,25(1):65-69.
[4] Wallia A,Molitch ME. Insulin therapy for type 2 diabetes mellitus [J]. JAMA,2014,311(22):2315-2325.
[5] 伊再提古丽·木提拉,玛依努·玉苏甫,阿瓦古丽·托合提,等.维吾尔族T2DM患者血清空腹C-肽水平与糖尿病家族史的关系[J].中国现代医学杂志,2017,27(12):75-79.
[6] 陈明云,李婷婷,张蓉,等.成人隐匿性自身免疫性糖尿病合并非酒精性脂肪肝的临床特征及其与血清C肽水平的关系[J].中华医学杂志,2015,95(44):3575-3578.
[7] 中华中医药学会糖尿病分会.糖尿病中医诊疗标准[J].世界中西医结合杂志,2011,6(6):540-547.
[8] 郭家权,蔡坤,吴坤芳,等.血小板参数、D-二聚体和纤维蛋白原的变化与糖尿病患者血管病变的关系[J].广东医学,2014,35(15):2402-2403.
[9] Maleckas A,Venclauskas L,Wallenius V,et al. Surgery in the treatment of type 2 diabetes mellitus [J]. Scand J Surg,2015,104(1):40-47.
[10] Tadic M,Cuspidi C. Type 2 diabetes mellitus and atrial fibrillation:From mechanisms to clinical practice [J]. Arch Cardiovasc Dis,2015,108(4):269-276.
[11] Tadic M,Cuspidi C. The influence of type 2 diabetes on left atrial remodeling [J]. Clin Cardiol,2015,38(1):48-55.
[12] 刘品力,陈燕玲,王春城,等.2型糖尿病患者凝血功能与血管病变的相关性分析[J].中国老年学杂志,2016, 36(7):1615-1616,1617.
[13] 杨维娜,王璇,蓝茜,等.2型糖尿病并发周围血管病变的临床流行病学分析[J].西安交通大学学报:医学版,2013,34(1):73-76.
[14] Lei X,Basu D,Li Z,et al. Hepatic overexpression of the prodomain of furin lessens progression of atherosclerosis and reduces vascular remodeling in response to injury [J]. Atherosclerosis,2014,236(1):121-130.
[15] 唐振媚,林芳,黄群英,等.2型糖尿病高血糖与炎症两者联合对血管病变的影响[J].中国医药导报,2014,11(3):50-53.
[16] 赵欣,申乐,许力,等.糖尿病与神经病理性疼痛和瘙痒[J].基础医学与临床,2016,36(7):1021-1025.
[17] Yu W,Ying H,Tong F,et al. Protective effect of the silkworm protein 30Kc6 on human vascular endothelial cells damaged by oxidized low density lipoprotein(Ox-LDL)[J]. PLoS One,2013,8(6):e68746.
[18] 包金兰,黄灿霞,蒋捷羽,等.非糖尿病急性冠脉综合征住院患者HDL-C、LDL-C/HDL-C水平回顾性分析[J].中山大学学报:医学科学版,2015,36(6):906-911.
[19] 刘谦.C肽与动脉粥样硬化的研究进展[J].中国动脉硬化杂志,2016,24(7):753-756.
[20] 王凯军.C肽与糖尿病慢性并发症关系的研究进展[J].中国医师杂志,2011,2(z2):223-224.
[21] Fernández-Friera L,Ibá?觡ez B,Fuster V. Imaging subclinical atherosclerosis:is it ready for prime time? A review [J]. J Cardiovasc Transl Res,2014,7(7):623-634.