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Study on the Relationship Between Visfatin, Tumor Necrosis Factor-α and Type 2 Diabetic Patients with Macrovascular Complications

Author: ZhaoDi
Tutor: LiHua
School: Zhengzhou University
Course: Geriatrics
Keywords: Type 2 Diabetes mellitus Visfatin Tumor necrosis factor-α Macrovascular complications
CLC: R587.1
Type: Master's thesis
Year: 2010
Downloads: 64
Quote: 0
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Abstract


Objictive:Type 2 diabetes mellitus have a high incidence of macro-vascular complication. Macroangiopathy refers primarily to the aorta, coronary, cerebral arteries, renal arteries and limb peripheral arteries and other large, medium artery atherosclerosis. The common clinic disease is coronary heart diaease, cerebral stroke, lower limbs arteriosclerosis and gangrene, et al. In diabetic patients, mortality and disability are mainly related to the presence of chronic macro-vascular complications. The pathogenic mechanism of diabetic vascular complications is very complicated. Studies have shown that the pathological changes are atherosclerosis (atherosclerosis, As), the main pathological basis is formed by multi-factor interaction of chronic and subclinical inflammation and insulin resistance caused by inflammation. Visfatin is a newly discovered adipocytokines, It has the role of combining and activating the insulin receptor and has the role of insulin analog, It participated in glucose andlipid metabolism. The study found that visfatin is closely linked with insulin resistance, diabetes, atherosclerosis, obesity, and so on. Tumor necrosis factor-a (TNF-a) from a variety of cells involved in chronic inflammation and insulin resistance. In order to explore the relationship between the visfatin or tumor necrosis factor-a and the diabetic macro-vascular complication, the levels of visfatin or tumor of different groups were measured by ELISA.Methods:60 patients with T2DM (1999 WHO diagnostic standards) were selected for this study. They are from the inpatients of Geriatrics of the First Affiliated Hospital of Zhengzhou University in January 2009 to June 2009. They are in line with 1999 WHO classification and diagnosis standards of diabetes. They were divided into two groups based on the presence or absence of diabetic macro-vascular complications (MVC) (Diabetic macro-vascular complications are 30 case and Non-diabetic macro-vascular complications are 30). Macro-vascular complications selected must meet one of the following criteria at least:①dynamic ECG and echocardiography or coronary angiography confirmed the clinical coronary artery disease;②head CT confirmed cerebral infarction;③Artery Doppler ultrasound found carotid and (or) pairs of lower extremity arterial wall sclerosis plaques sooner or thrombosis. The 30 cases of normal control group from the healthy volunteers who come to my hospital for routine health examination at the same period. Visfatin and tumor necrosis factor-a were measured by enzyme linked immunosorbent assay (ELISA), and others markers related to macro-vascular complications were also measured. We analyzed the change tendency and influential factors of visfatin and tumor necrosis factor-a in type 2 diabetic patients with or without macro-vascular complications. All the statistical analysis were dealt with SPSS 17.0 software.Results:(1) Compared with normal controls, the serum levels of Visfatin and TNF-a were significantly increased (P<0.01,P<0.01); Compared with Non-MVC group, the serum levels of Visfatin and TNF-a were increased (P<0.05,P<0.01) in MVC group.(2) By multiple stepwise regression analysis, WHR、HOMA-IR、BMIand FPG were the influential factors of Visfatin (F=175.442, P<0.01).(3) By multiple stepwise regression analysis, HOMA-IR、HbA1c and BMI were the influential factors of TNF-α(F=169.728, P<0.01).(4) The multiple stepwise logistic regression analysis was used to define the association between Visfatin, TNF-α, other related indexes and macrovascular complications. Age, Visfatin, TNF-αwere related significantly with diabetic macrovascular complications.Conclusion: (1) The serum levels of visfatin and TNF-αare both increased remarkably in type 2 diabetis mellitus as compared with normal control group, this indicate visfatin and tumor necrosis factor-αare related to the occurrence and development of type 2 diabetes mellitus. (2) The serum levels of visfatin and TNF-αare both increased remarkably in MVC group as compared with Non-MVC group, Also, The multiple stepwise logistic regression analysis indicates that visfatin and TNF-αare important risk factors of diabetic macrovascular complications, those indicate visfatin and tumor necrosis factor-αare related to the formation of macrovascular complications in type 2 diabetes. (3) WHR、HOMA-IR、BMI and FPG were the influential factors of visfatin, HOMA-IR、HbA1c and BMI were the influential factors of TNF-α, Those suggest that the elevated levels of visfatin, tumor necrosis factor-αin type 2 diabetes mellitus due to obesity, insulin resistance, diabetes and other factors, And they influence each other and jointly accelerate the development of diabetic angiopathies.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Islet disease > Diabetes
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