摘要
目的探讨中性粒细胞弹性蛋白酶(NE)对2型糖尿病(T2DM)合并动脉粥样硬化斑块的诊断价值。方法选取2018年4月—2020年4月杭州师范大学附属医院收治的201例T2DM患者为研究对象,根据血管B超检查结果分为T2DM组(无动脉粥样硬化斑块)102例、T2DM+斑块组(有动脉粥样硬化斑块)99例;另选取同期在本院健康体检的99名志愿者为对照组;比较3组对象血清NE水平及心血管相关指标[包括α1-抗胰蛋白酶(A1AT)、糖化血红蛋白(HbA1C)、FPG、TC、TG、超敏(hs)-CRP、LDL-C、HDL-C等],分析血清NE水平与心血管相关指标的相关性以及各项指标对T2DM合并动脉粥样硬化斑块的诊断效能。结果3组对象血清NE水平及心血管相关指标比较,差异均有统计学意义(均P<0.05)。血清NE水平与A1AT、HDL-C均呈负相关(r=-0.205、-0.140,均P<0.05),与HbA1C、FPG、TC、TG、hs-CRP、LDL-C均呈正相关(r=0.791、0.825、0.687、0.772、0.670、0.590,均P<0.05)。NE、A1AT、FPG、TC、hs-CRP、LDL-C、HDL-C诊断T2DM合并动脉粥样硬化斑块的AUC分别为0.928、0.841、0.986、0.754、0.778、0.664、0.657;NE+A1AT、NE+FPG、A1AT+FPG诊断T2DM合并动脉粥样硬化斑块的AUC分别为0.997、0.986、0.979,灵敏度分别为0.970、0.960、0.980,特异度分别为0.971、0.971、0.980。结论NE联合A1AT、FPG等心血管相关指标能有效提高对T2DM合并动脉粥样硬化斑块的诊断效能。
Objective To investigate the detection of serum levels of neutrophil elastase(NE)and cardiovascular markers for diagnosis of atherosclerotic plaques in patients with type 2 diabetes mellitus(T2DM).Methods A total of 201T2DM patients were enrolled from Affiliated Hospital of Hangzhou Normal University from April 2018 to April 2020,including102 cases without atherosclerotic plaques(group B)and 99 cases with atherosclerotic plaques(group C);99 healthy subjects were selected as controls(group A).The age,gender,duration of diabetes,body mass index(BMI)were documented;serum levels of NE,α1-antitrypsin(A1AT),glycated hemoglobin(HbA1C),fasting blood glucose(FPG),hypersensitive C-reactive protein(hs-CRP),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)were detected in all subjects.Pearson correlation was used to analyze the relationship between NE and other indicators,multiple Logistic regression was used to analyze the risk factors of atherosclerosis in T2DM patients,and ROC analysis was applied to explore the value of indicators for predicting atherosclerosis in T2DM patients.Results The levels of NE,HbA1C,FPG,TC,TG,hs-CRP and LDL-C in groups B and C were significantly higher than those in group A,while the levels of NE,HbA1C,FPG,TC,TG,hs-CRP and LDL-C in group C were significantly higher than those in group B(P<0.05).The levels of A1AT and HDL-C in groups B and C were significantly lower than those in group A,while the levels of A1AT and HDL-C in group C were significantly lower than those in group B(P<0.05).Pearson correlation analysis showed that NE was negatively correlated with A1AT and HDL-C(r=-0.205,-0.140,both P<0.05),and positively correlated with HbA1C,FPG,TC,TG,hs-CRP and LDL-C(r=0.791,0.825,0.687,0.772,0.670,0.590,all P<0.05).ROC curve analysis showed that the AUC of NE,A1AT,FPG,TC,hs-CRP,LDL-C and HDL-C for diagnosing atherosclerotic plaques in T2DM patients were 0.928,0.841,0.986,0.754,0.778,0.664,0.657,respectively;the AUC of NE
作者
杨燕丽
张秋玲
王婧
YANG Yanli;ZHANG Qiuling;WANG Jing(Department of Endocrinology,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China)
出处
《浙江医学》
CAS
2022年第23期2516-2520,共5页
Zhejiang Medical Journal
基金
杭州市卫生科技计划项目(2018A24)。
