Research On The Associations Of Fetuin-a And Type2Diabetic Macroangiopathy

Objective The aim of this study was determine the level of AHSG by enzyme-linked immunosorbent assay (ELISA), observe the level of AHSG among the. patients of T2DM, impaired glucose tolerance (IGT) and macroangiopathy. AT the same time to analyse the state of insulin resistence and the function of (3-cell of islet with Homeostasis model assessment-insulin resistance index(HOMA-IR)and islet secretive function index(IFI).Investigate the level of Fetuin-A in serum and mechanism of action in patients combined large vascular disease in T2DM. To provide a theoretical basis for the prevention and treatment of diabetes with macroan-giopathy.Methods1)202patients who visited in the hospital physical examination center, department of Endocrinology and Cardiology. Blood glucose concentration was measured by gluose oxidase method.and insulin and C-peptide levels were determined by Chemiluminescence method.To analyse the state of insulin resistence and the function of p-cell of islet with Homeostasis model assessment-insulin resistance index(HOMA-IR)and islet secretive function index(IFI).2) All subjects were measured blood pressure (BP). body weight(BW) and height(H). waistline(WC), hipline(WH), calculated constitutional index (BMI) and waist-to-hip ratio(WHR). At the same time the patients fasting total cholesterol (TC), triglyceride (TG). glycosylated hemoglobin (HbAlc) were also measured. All patients were divided into5groups according to level of blood sugar and glucose tolerance, constitutional index and macroangiopathy:normal control group (CON); Impaired glucose tolerance group (IGT); Type2diabetes mellitus group (T2DM); T2DM combined macroangiopathy group(DMA) and macroangiopathy group (MA).3) Determine the level of AHSG by enzyme-linked immunosorbent assay (ELISA).Results1) General condition of patients:In the202patients(Male103cases, Female99cases), mean age is65.0±9.8. The patients were divided into5groups: Normal control group (CON).35cases:Impaired glucose tolerance group (IGT).45cases;Type2diabetes mellitus group (T2DM),40cases;T2DM combined macroangiopathy group(DMA),40cases and macroangiopathy group (MA),42cases.The patients’age and gender have the comparability.2) In the IGT and T2DM groups, the index of BMI, WHR, TG and HbAlc[(26.5±2.5)Kg/m2,(1.05±0.70)、(3.8±1.1) mmol/L、(5.9±0.9)%]and [(25.5±2.4)Kg/m2、(1.02±0.60)、(3.2±1.5) mmol/L.(7.3±0.8)%] were statistically significant than that of the normal control group[(23.21±1.5) Kg/m2、(0.85±0.5)、(1.8±0.3) mmol/L、(4.8±0.5)%](P<0.01)3) In the impaired glucose tolerance group (IGT), type2diabetes mellitus(T2DM) and T2DM combined macroangiopathygroups (DMA), the index of HOMA-IR[(1.2±0.4)、(1.3±0.4)、(1.0±0.3)]were significantly highter than that of the normal group(CON)(0.4±0.3)(P<0.01), but no significantly difference among the groups (P>0.05).In the macroangiopathy group/the HOMA-IR(0.5±0.3)were lower that of the other groups(P<0.01).4) In the IGT and T2DM groups, the level of FINS[(18.1±3.4) uIU/ml (15.1±3.0) uIU/ml] were significantly higher than that of normal group(P<0.05).The indexs of C-peptide and IFI [(3.5±1.2)ng/ml、(0.4±0.5) and (3.4±1.2) ng/ml、(0.3±0.4)] have no significant differences.(P>0.05).5) In the CON、IGT、T2DM、DMA、MA groups, the levels of AHSG were[(456.19±72.54)mg/L,(508.99±64.25)mg/L,(599.29±126.22)mg/L,(361.92±86.57)mg/L,(355.82±76.38)mg/L].The result shows that the AHSG level of the IGT and T2DM were significantly higher than that of the other groups (P<0.01). In the DMA and MA groups, the index of AHSG were lower than that of the normal group (P<0.01), but no significant in two groups (P>0.05).6) Univariate linear correlation and regression analysis shows the age of patients have negative correlation with the level of AHSG in the normal group.In the IGT and T2DM groups,serum AHSG to be positively correlated with HOMA-IR, BMI, HbAlc.WHR,TG and HbAlc(P<0.01).But no correlation between AHSG and HOMA-IR,gender.age.BP.BMI,WHR. TG,TC. HDL-C, LDL-C in the DMA and MA groups.Conclusion Fetuin-A may be involved in the formation of insulin resistance. It is the causative factors of occurrence and development of diabetes, also participated in the formation and development of macroangiopathy.