摘要
目的探究血清载脂蛋白A1/载脂蛋白B(apolipoprotein A1/apolipoprotein B,ApoA1/B)、同型半胱氨酸(homocysteine,Hcy)、脂蛋白a[lipoprotein(a),Lp(a)]在2型糖尿病(type 2 diabetes mellitus,T2DM)合并微血管并发症患者中的变化及预测价值。方法选取T2DM患者134例,根据是否合并微血管并发症分为合并微血管并发症组(56例)与无微血管并发症组(78例),比较2组临床资料、血清ApoA1/B、Hcy、Lp(a)水平,采用Pearson相关性分析血清ApoA1/B、Hcy、Lp(a)与实验室指标的相关性,Logistic回归分析T2DM合并微血管并发症的影响因素,受试者工作特征(receiver operating characteristic,ROC)曲线评价血清ApoA1/B、Hcy、Lp(a)对T2DM合并微血管并发症的单独及联合预测价值。结果合并微血管并发症组血清ApoA1/B水平低于无微血管并发症组,Hcy、Lp(a)水平高于无微血管并发症组(P<0.05);血清ApoA1/B与糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、空腹血糖(fasting blood-glucose,FBG)、餐后2 h血糖(2 h postprandial plasma glucose,2 hPG)、血清总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)呈负相关,Hcy、Lp(a)与FBG、2 hPG、HbA1c、TC、TG呈正相关(P<0.05);病程、BMI、合并高血压、血清ApoA1/B、Hcy、Lp(a)是T2DM合并微血管并发症的影响因素(P<0.05);血清ApoA1/B、Hcy、Lp(a)联合预测的AUC为0.878,敏感度为73.21%,特异度为88.46%,优于各指标单独预测(P<0.05)。结论T2DM合并微血管并发症患者血清ApoA1/B表达水平明显降低、Hcy、Lp(a)表达水平明显升高,检测其水平变化可辅助临床预测T2DM患者微血管并发症发生,为患者病情评估、预防及治疗提供有效参考依据。
Objective To explore the changes and combined predictive value of serum apolipoprotein A1/apolipoprotein B(ApoA1/B),homocysteine(Hcy),and lipoprotein(a)[Lp(a)]in type 2 diabetes mellitus(T2DM)patients with microvascular complications(MVC).Methods A total of 134 T2DM patients were selected.According to presence of combined MVC,they were divided into MVC group(n=56)and non-MVC group(n=78).The clinical data,serum ApoA1/B,Hcy,and Lp(a)levels were compared between two groups,and the correlation between serum ApoA1/B,Hcy,and Lp(a)and laboratory indicators was analyzed by Pearson correlation analysis.Logistic regression was used to analyze the influencing factors of T2DM with MVC,and receiver operating characteristic(ROC)curve was used to evaluate the single and combined predictive value of serum ApoA1/B,Hcy,and Lp(a)on T2DM with MVC.Results Serum ApoA1/B in MVC group was lower than that in non-MVC group,and Hcy and Lp(a)were higher than those in non-MVC group(P<0.05).Serum ApoA1/B was negatively correlated with glycosylated hemoglobin(HbAlc),fasting blood-glucose(FBG),2 h postprandial plasma glucose(2 hPG),serum totalcholesterol(TC),and triglyceride(TG),and Hcy and Lp(a)were positively correlated with FBG,2 h PG,HbA1c,TC,and TG(P<0.05).Course of disease,body mass index,combined hypertension,serum ApoA1/B,Hcy,and Lp(a)were influencing factors of T2DM with MVC(P<0.05).The AUC of combined serum ApoA1/B,Hcy,and Lp(a)in predicting T2DM with MVC was 0.878,the sensitivity was 73.21%,and the specificity was 88.46%,which was better than the individual prediction of each index(P<0.05).Conclusion The expression level of serum ApoA1/B in T2DM patients with MVC is significantly reduced,and the expression levels of Hcy and Lp(a)are significantly increased.Detecting changes in their level can help predict the occurrence of MVC in patients with T2DM in clinical practice,and provide an effective reference for patient condition assessment,prevention and treatment.
作者
王志敏
WANG Zhi-min(Department of Laboratory Medicine, the Hospital of Shunyi District, Beijing 101300, China)
出处
《河北医科大学学报》
CAS
2021年第9期1022-1026,1036,共6页
Journal of Hebei Medical University
基金
北京市卫生科技发展专项基金(2017-7-270)。
关键词
糖尿病
2型
微血管并发症
预测价值
diabetes mellitus,type 2
microvascular complications
predictive value
