Study Of Correlation Between Serum Adiponectin,retinol Binding Protein4and Macrovascular Disease In Type2Diabetic

Diabetes mellitus (diabetes mellitus, DM) is determined by geneticand environmental factors caused by a group of chronic hyperglycemia asthe characteristics of metabolic disorders, incidence is based on insulinresistance and insulin secretion defects, including type2diabetes mellitus(Type2Diabetes mellitus, T2DM) is a major threat to human health,accounting for all about95%of diabetic patients. Type2diabetes is oneof the chronic complications of diabetes mellitus, mainly refers to themedium or large artery atherosclerosis and secondary thrombus formationin the lumen of the artery stenosis and occlusion, the common clinicaldisease is coronary heart disease, ischemic cerebrovascular disease,carotid artery lesions and lower extremity arteriosclerotic gangrene;macrovascular disease is one of the leading causes of death in diabeticpatients, according to statistics60-80%in type2diabetic patients die frommacrovascular disease, study of diabetic large vascular disease riskfactors and early intervention, is conducive to the prevention of diabeticmacroangiopathy. Adiponectin (adiponectin, APN) is found in recentyears by white adipose cell specific secretion of a protein, research showsthat it has anti-inflammatory, atherosclerosis, regulation of lipidmetabolism, increased insulin sensitivity and other functions. Retinolbinding protein4(retinol bingding protein4, RBP4) is a new cycle ofadipose-derived factors, mainly in the liver expression, responsible forbinding, transport in plasma vitamin A, recent studies found that, RBP4intype2diabetes mellitus and impaired glucose tolerance, insulin resistanceand inadequate insulin secretion. Studies have shown that adiponectin,retinol binding protein4levels and type2diabetic macrovascular disease occurrence, development and prognosis of close relationship. Toinvestigate the serum APN and RBP4levels in type2diabetes and itsvascular lesions occur, the action in developing a process, for acomprehensive understanding, understanding of diabetes and its vascularlesions has important significance.The study of randomly selected in2010March-2011December in ourhospital endocrine clinic or ward in patients with type2diabetes, are inline with the WHO1999diagnostic criteria for diabetes mellitus.According to whether the combined lesion of large vessels, the T2DMpatients were divided into T2DM with large blood vessel lesion groupand T2DM group. T2DM alone group (B group)38cases,21weremale,17female, mean age (63.3+7.6) at the age of. T2DM with largeblood vessel lesion group (C group)36cases,17were male,19female,mean age (60.6+7.7) at the age of. The healthy control group (group A):random selection period in our hospital health examination in32cases,18were male,14female, mean age (58.5+5.4) at the age of. Subjectsmeasured height, weight, blood pressure, BMI was calculated; fastingvenous blood was sampled to check, fasting plasma glucose (FPG),triglyceride (TG three), total cholesterol (TC), high density lipoproteincholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C),glycosylated hemoglobin (HbA1c) assay; insulin (FINS) using theenzyme immunoassay method for the determination of; human serumadiponectin (APN) and serum retinol binding protein4(RBP4) usingenzyme-linked immunosorbent assay (ELISA) principle of the doubleantibody sandwich method for quantitative determination of, insulinresistance index (HOMA-IR)=(FIN×FBG)/22.5. The study of datausing SPSS17.0statistical software for data analysis, measurement data in—x+s, two sets of measurement data were compared with t test; twocorrelations between factors using the linear correlation analysis, multiplecorrelations between factors using a multivariate stepwise regressionanalysis. All the tests are bilateral, P <0.05, with statistical significance. The clinical data statistics and analysis, we found that:1) the healthycontrol group (group A), T2DM alone group (group B), T2DM withlarge blood vessel lesion group (group C) APN decreased gradually,serum APN level of B group was lower than that in A group, differencehas statistical sense (P <0.05), group C serum APN levels weresignificantly lower than those in B group, difference has statistical sense(P <0.05), the differences between the three groups was significant inthe elimination of BMI factors still exist; RBP4gradually increased,serum APN level of B group was significantly higher than that in A group,difference has statistical sense (P <0.05), C group serum APN levelswere significantly higher than those in B group, difference has statisticalsense (P <0.05), the differences between the three groups was significantin the elimination of BMI factors still exist.2) serum APN and course ofdisease, BMI, SBP, FPG, HbA1c, TG, LDL-C, FINS, HOMA-IRnegatively, correlation coefficient, respectively (r=-0.379, P <0.01; r=-0.637, P <0.01; r=-0.469, P <0.05; r=-0.142, P <0.01; r=-0.469, P<0.01; r=-0.326, P <0.01; r=-0.528, P <0.01; r=-0.424, P <0.01; r=-0.575, P <0.01), and HDL was positively related to C, correlationcoefficient (r=0.583, P <0.05), and gender, age, DBP, TC, RBP4had nosignificant correlation (P>0.05). Taking APN as dependent variables,gender, age, course of disease, BMI, SBP, DBP, FPG, HbA1c, TC, TG,LDL-C, HDL-C, FINS, HOMA-IR, RBP4as independent variables,multivariate stepwise regression analysis showed that FPG, HOMA-IR,FINS, HDL-C and serum APN linear regression relation, becomeinfluence serum APN the remarkable factor (coefficient of determinationfor R2=0.489, P <0.01).3) correlation analysis showed that Pearson,RBP4negatively correlated with HDL-C, correlation coefficient (r=-0.426, P <0.05), and BMI, SBP, FPG, HbA1c, TG, LDL-C, HOMA-IRwas positively related, the correlation coefficient respectively (r=0.584,P <0.01; r=0.427, P <0.01; r=0.485, P <0.01; r=0.364, P <0.01; r=0.347, P <0.01; r=0.406, P <0.01; r=0.573, P <0.01), and sex, age, course of disease, DBP, TC, FINS, APN had no significant correlation (P>0.05). Taking RBP4as dependent variables, gender, age, course ofdisease, BMI, SBP, DBP, FPG, HbA1c, TC, TG, LDL-C, HDL-C, FINS,HOMA-IR, APN as independent variables, multivariate stepwiseregression analysis showed that HOMA-IR, LDL-C, FINS, FPG andserum RBP4linear regression relation, become influence serumRBP4significant factors (determination coefficient R2=0.484, P <0.01).In conclusion, the study results, and the reference to the domesticand foreign experts’ research progress, we can draw the followingconclusions:1) in type2diabetic patients with serum APN levelscompared to healthy individuals was significantly reduced, and withvascular lesions of lower; type2diabetes mellitus patients with serumRBP4levels were significantly elevated compared to healthy individuals,and with large blood vessel lesions are higher; serum adiponectin andretinol binding protein4on the prediction of diabetes and diabeticmacrovascular disease has important significance.2) the levels of serumAPN, RBP4are closely associated with insulin resistance. Serum APNwas negatively correlated with HOMA-IR, serum RBP4positivelycorrelated with HOMA-IR.3) for large vessel disease serum APN is aprotective factor, and serum RBP4as important risk factor.4) increase ofserum APN concentrations, serum RBP4concentrations may become thenew improvement of insulin resistance and treatment of diabetes and itscomplications in new ways.