摘要
目的探讨血浆肾素活性(PRA)、C1q/TNF相关蛋白3(CTRP3)与2型糖尿病(T2DM)患者颈动脉粥样硬化的关系。方法选择T2DM患者137例,根据颈动脉内膜—中层厚度分为斑块组83例、无斑块组54例。收集两组一般临床资料[性别、年龄、BMI、血压(收缩压、舒张压)、基础疾病(高血压、高脂血症)、吸烟史、饮酒史、心脑血管疾病家族史、饮食方式、运动方式]、实验室检查资料[TC、TG、LDL-C、HDL-C、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、PRA、CTRP3]。比较两组一般临床资料和实验室检查资料,将两组上述有统计学差异指标纳入多元逐步Logistic回归模型,分析影响T2DM并发颈动脉粥样硬化的危险因素。采用受试者工作特征(ROC)曲线评估血浆PRA、CTRP3水平预测T2DM并发颈动脉粥样硬化的效能。结果两组一般临床资料共纳入12个因素,单因素分析发现,两组BMI、收缩压、有吸烟史例数、合并高血压例数、合并高脂血症例数、不合理饮食例数、缺乏运动例数比较差异均有统计学意义(P均<0.05),而性别构成、年龄、舒张压、有饮酒史例数、有心脑血管疾病家族史例数比较差异均无统计学意义(P均>0.05);两组实验室检查资料共纳入10个因素,单因素分析发现,两组TC、FPG、FINS、HOMA-IR、HbA1c、PRA、CTRP3比较差异均有统计学意义(P均<0.05),两组TG、HDL-C、LDL-C比较差异均无统计学意义(P均>0.05)。多元逐步Logistic回归分析发现,收缩压、TC、HbA1c、PRA、CTRP3是T2DM并发颈动脉粥样硬化的危险因素(P均<0.05)。ROC曲线分析显示,血浆PRA水平预测T2DM并发颈动脉粥样硬化的曲线下面积(AUC)为0.731(95%CI:0.644~0.817),其截断(cut off)值为4.21μg/(L·h),此时其预测T2DM并发颈动脉粥样硬化的敏感度为72.29%、特异度为79.63%;血浆CTRP3水平预测T2DM并发颈动脉粥样硬化的AUC为0.801(95%CI:0.720~0.881),其cut o
Objective To investigate the relationship between plasma renin activity(PRA),C1q/TNF-related protein 3(CTRP3)and carotid atherosclerosis in patients with type 2 diabetes mellitus(T2DM).Methods Totally 137 patients with T2DM were selected and divided into the plaque group of 83 cases and non-plaque group of 54 cases according to carotid intima-media thickness.The general clinical data[age,gender,BMI,blood pressure(systolic blood pressure,diastolic blood pressure),basic diseases(hypertension,hyperlipidemia),smoking history,drinking history,family history of cardiovascular and cerebrovascular diseases,diet and exercise mode]and laboratory examination data[TC,TG,LDL-C,HDL-C,FPG,fasting insulin(FINS),insulin resistance index(HOMA-IR),glycosylated hemoglobin(HbA1c),PRA,CTRP3]were collected.The general clinical data and laboratory examination data of the two groups were compared.The above indexes with statistical difference were included in the multiple stepwise Logistic regression model,the risk factors affecting T2DM complicated with carotid atherosclerosis was analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of plasma PRA and CTRP3 levels in predicting T2DM complicated with carotid atherosclerosis.Results Twelve factors were included in the general clinical data of the two groups.Univariate analysis showed that there were significant differences in BMI,systolic blood pressure,smoking history,hypertension,hyperlipidemia,unreasonable diet and lack of exercise between the two groups(all P<0.05);there were no significant differences in gender,age,diastolic blood pressure,drinking history,family history of cardiovascular or cerebrovascular disease(all P>0.05).Ten factors were included in the laboratory examination data of the two groups.Univariate analysis showed that there were significant differences in TC,FPG,FINS,HOMA-IR,HbA1c,PRA,and CTRP3 between the two groups(all P<0.05),but there was no significant difference in TG,HDL-C or LDL-C between the two groups(all P>0.05).Multiple st
作者
陈毅光
刘枘岢
李雯翀
周敏华
朱咏瑶
CHEN Yiguang;LIU Ruike;LI Wenchong;ZHOU Minhua;ZHU Yongyao(Songshanhu Central Hospital,Dongguan523320,China)
出处
《山东医药》
CAS
2020年第34期29-33,共5页
Shandong Medical Journal
基金
广东省自筹经费类科技计划项目(2017ZC0155)。
