摘要
目的 探讨1型糖尿病(T1DM)儿童血清分泌型Klotho (sKlotho)、骨桥蛋白(OPN)水平与糖代谢紊乱及微血管并发症的关系。方法 选择2021年1月至2023年1月诊治T1DM患儿116例为研究对象(TIDM组),根据是否存在微血管并发症分为并发症组36例和无并发症组80例。另选择同期拟行择期手术的60例腹股沟斜疝患儿为对照组。酶联免疫吸附实验检测各组血清sKlotho、OPN水平。Pearson分析T1DM患儿血清sKlotho、OPN与糖代谢指标[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)]的相关性。多因素Logistic回归分析影响TIDM儿童微血管并发症发生的危险因素。受试者工作特征曲线(ROC)分析血清sKlotho、OPN对TIDM儿童微血管并发症发生的预测价值。结果 T1DM组血清sKlotho水平低于对照组,差异有统计学意义(t=42.141,P=0.000)。T1DM组血清OPN水平,高于对照组差异有统计学意义(t=20.629,P=0.000)。并发症组血清sKlotho水平低于无并发症组,而OPN水平高于无并发症组,差异具有统计学意义(均P<0.05)。T1DM患儿血清sKlotho与FPG、FINS、HOMA-IR、HbA1c呈显著负相关,血清OPN与FPG、FINS、HOMA-IR、HbA1c呈显著正相关(均P<0.05)。sKlotho是影响T1DM患儿微血管并发症发生的独立保护因素,OPN是影响T1DM患儿微血管并发症发生的独立危险因素。血清sKlotho、OPN二者联合诊断T1DM患儿并发微血管并发症的曲线下面积为0.850,大于两指标单独检测0.778、0.752,差异有统计学意义(Z=5.183、4.349,P均<0.001)。结论 T1DM患儿血清sKlotho降低,OPN升高,两者与T1DM患儿糖代谢紊乱有关,两者联合有助于评估微血管并发症的发生。
Objective To investigate the correlation of serum levels of secretory Klotho(sKlotho),and osteopontin(OPN) with glucose metabolism disorder and microvascular complications in children with type 1 diabetes mellitus(TIDM).Methods A total of 116 children with T1DM diagnosed and treated in our hospital from January 2021 to January 2023 were selected as the study subjects(TIDM group).According to the presence or absence of microvascular complications,they were divided into complication group(n=36) and non-complication group(n=80).Another 60 children with indirect inguinal hernia managed by an elective surgery in our hospital during the same period were selected as the control group.The serum levels of sKlotho and OPN in each group were detected by enzyme linked immunosorbent assay(ELISA).Pearson correlation was performed to analyze the correlation of serum sKlotho and OPN with glucose metabolism indicators in children with T1DM,including fasting plasma glucose(FPG),fasting insulin(FINS),homeostatic model assessment for insulin resistance(HOMA-IR),and glycosylated hemoglobin(HbA1c).Multivariate logistic regression analysis was used to analyze the risk factors for microvascular complications in children with TIDM.The predictive value of serum sKlotho and OPN in the occurrence of microvascular complications in children with TIDM was analyzed by plotting the receiver operating characteristic(ROC) curve.Results The serum sKlotho level in T1DM group was significantly lower than that of control group(t=42.141,P=0.000).The serum OPN level in T1DM group was significantly higher than that of control group(t=20.629,P=0.000).The serum sKlotho level in the complication group was significantly lower than that in the non-complication group,while the levels of OPN was significantly higher than those of the non-complication group(all P<0.05).In children with T1DM,serum sKlotho was significantly negatively correlated with FPG,FINS,HOMA-IR,and HbA1c,while serum OPN was significantly positively correlated with FPG,FINS,HOMA-IR,and HbA1c(
作者
王琦
邢晓婧
杨丽微
WANG Qi;XING Xiaojing;YANG Liwei(Department of Pediatrics,Jiamusi Center Hospital,Heilongjiang,Jiamusi 154002,China;不详)
出处
《河北医药》
CAS
2024年第1期44-47,51,共5页
Hebei Medical Journal
基金
黑龙江省医药卫生科研课题(编号:2020155)。
