凝血酶激活的纤溶抑制物、纤溶酶原激活剂抑制物-1与非肥胖型2型糖尿病患者代谢参数的相关性

摘要

目的 探讨凝血酶激活的纤溶抑制物(TAFI)、纤溶酶原激活剂抑制物-1(PAI-1)与非肥胖型2型糖尿病患者代谢参数的相关性.方法 将57例有血管病变的非肥胖型2型糖尿病患者分为实验1组,39例无血管病变的非肥胖型2型糖尿病患者分为实验2组,80例健康者作为对照组.检测TAFI、PAI-1、血管性假性血友病因子(vWF)及纤维蛋白原(FIB)水平,测定空腹血糖、糖化血红蛋白、空腹胰岛素水平、脂代谢指标及体重指数等参数.结果 与对照组比较,实验1组TAFI、PAI-1、vWF、FIB水平显著升高(P＜0.01)；与对照组比较,实验2组TAFI、PAI-1、vWF、FIB水平升高(P＜0.05)；与实验2组比较,实验1组TAFI、PAI-l水平升高(P＜0.05).Pearson相关分析表明TAFI与空腹血糖、糖化血红蛋白呈正相关(分别为r=0.29,P＜0.05; r=0.71,P＜0.01),PAI-1与体重指数呈正相关(r=0.33,P＜0.05),TAFI与PAI-1之间无相关性.结论 非肥胖型2型糖尿病患者凝血活性增强,存在低纤溶状态；非肥胖型2型糖尿病患者血浆中TAFI水平升高与长期的高血糖有关,而脂肪蓄积是PAI-1增多的主要根源.%Objective To assess the effect of thrombin-activatable fibrinolysis inhibitor (TAFI), plasminogen activator inhibitor-1 (PAI-1) in non-obesity type 2 diabetic patients, and to investigate the relationship between TAFI, PAI-1 and clinical parameters of metabolism. Methods rnThe individuals confined to the enrolling criteria were divided into three groups. Group 1 included 57 cases of non-obesity type 2 diabetic patients with vascular lesion; group 2 consisted of 39 non-obesity type 2 diabetic patients with no vascular lesion; and the 80 enrolled healthy individuals were regarded as normal control group. The levels of plasma TAFI, PAI-1, von Wille-brand factor (vWF) and fibrinogcn (FIB) were measured. The changes of fasting blood glucose, glycosylated hemoglobin, fasting insulin, body mass index and lipid metabolism- indicators were detected as well. Results Compared with the plasmic levels of TAFI, PAI-1, vWF, FIB in normal control group, the levels in group 1 were obviously higher (P <0.01), and TAFI, PAI-1, vWF, FIB in group 2 dramatically increased with significant difference (P <0.05). Compared with the plasmic levels of TAFI, PAI-1 in group 2, the levels in group 1 obviously increased (P <:0.05). The significantly positive correlations were found between plasmic TAFI level and serum fasting blood glucose levels, or serum glycosylated hemoglobin levels (r=0.29, P <005; r=0.71, P <0.01 respectively). Another positive correlation was also observed between the plasmic PAI-1 level and body mass index (r= 0.33, P <0.05). There was no relationship between the changes of plasma PAI-1 and TAFI levels. Conclusion The findings suggest that the coagulation activity can be enhanced in non-obesity type 2 diabetic patients accompanied by decreased activity of fibrinoly-sis. The level increase of plasma TAFI is related with the long-term high blood sugar, which is a valuable marker to assess the deterioration of disease, and the fat accumulation is involved in the PAI-1 level increase in disease.