摘要
目的探讨老年2型糖尿病（T2DM）患者血清分泌型卷曲相关蛋白5（SFRP-5）与冠脉病变严重程度的相关性。方法选择2015年1月-2017年7月在西京医院心内科接受冠状动脉造影的476例老年T2DM患者纳入研究，根据造影检查结果分为冠脉病变组396例和对照组80例，计算冠脉病变组患者治疗的Gensini评分，检测所有患者血清SFRP-5及其他相关参数水平。结果冠脉病变组的体重指数、有无高血压、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL—C）和SFRP-5与对照组比较差异具有统计学意义（均P〈0．05）。Logistics多因素回归分析结果显示SFRP-5是老年T2DM患者发生冠脉病变的保护性因素（OR=0．412，95％C10．187-0．670，P=0．000）。根据Gensini评分结果将患者分成轻度病变组（〈20分）、中度病变组（20-40分）和重度病变组（〉40分），3个亚组分别与对照组比较，血清SFRP-5水平差异均有统计学意义（均P〈0．05）；3个亚组两两比较，重度病变组血清SFRP-5水平显著高于轻度病变组和中度病变组（均P〈0．05）。血清SFRP-5水平与Gensini评分呈负相关关系（r=-0．375，P=0．000）。Spearman相关性分析结果显示：对于冠脉病变组患者，血清SFRP-5水平与体重指数（r=-0．301，P=0．000）、糖尿病病程（r=-0．228，P=0．001）、HbA1c（r=-0．270，P=0．000）和LDL—C（r=-0．281，P=0．000）均呈负相关关系；对于对照组患者，血清SFRP-5水平仅与体重指数（r=-0．268，P=0．030）和HbA1c（r=-0．223，P=0．041）呈负相关关系。结论老年T2DM患者血清SFRP-5水平与其冠脉病变程度呈负相关关系，可用于评估T2DM患者大血管病变。
Objective To investigate the correlation between serum levels of secreted frizzled - related protein - 5 （ SFRP - 5 ） with the severity of coronary artery lesions in elderly patients with type 2 diabetes mellitus （T2DM）. Methods 476 elderly pa- tients with T2DM who underwent coronary angiogmphy in our hospital from January 2015 to July 2017 were recruited in this study. The patients were divided into the coronary lesions group （ n = 396） and control group （ n = 80） according to the examination of selective coronary angiographv. Gensini score was calculated. The serum level of SFRP - 5 and other risk factors were measured. Results There were significant differences in the body mass index, fasting plasma glucose （FPG） , hemoglobin Alc （HBAlc）, triglyceride （TG） , total cholesterol （TC）, low density lipoprotein cholesterol （LDL- C）, high density lipoprotein cholesterol （HDL- C） and SFRP - 5 between the coronary lesion group and control group （ P 〈 0. 05 ）. Multivariate logistic regression analysis showed that serum SFRP -5 was protective factor of coronary artery lesions for elderly T2DM patients （ OR = 0. 412, 95% CI 0. 187 - 0. 670, P = 0. 000）. According to Gensini score, the coronary lesion group were further divided into 3 subgroups, the mild lesions （ 〈 20） , the moderate lesions （20 to 40） and the severe lesions （ 〉 40） groups. There were significant differences in SFRP - 5 level between 3 subgroups and control group （P 〈 0. 05）. Among 3 subgroups, SFRP - 5 level in the severe lesions group was lower than mild and moderate lesions group （ P 〈 0. 05 ）. In T2DM patients with coronary artery disease, the levels of serum SFRP - 5 was negatively cor- related with Gensini score （ r = - 0. 375 ,P =0. 000）. Spearman correlation analysis showed that serum level of SFRP -5 was nega- tively correlated with body mass index （ r = - 0. 301 ,P =0. 000） , course of diabetes （ r = - 0. 228 ,P =0. 001 ） , HBAlc level （ r = - 0. 270,P =0. 000） and LDL - C level （ r = - 0. 281 ,P =0. 000） in the coronary lesion group. While, only body mass index （ r =- 0. 268,P =0. 030） and HBAlc level （ r =- 0. 223,P =0. 041 ） was negatively correlated with SFRP-5 in the control group. Conclusion The serum level of SFRP - 5 is negatively correlated with the severity of coronary artery lesions in elderly patients with T2DM, and can be used as an independent predictor of diabetic macroangiopathy.
作者
金屏
郭红
徐臣年
俞世强
Jin Ping;Guo Hong;Xu Chennian;Yu Shiqiang(Department of Cardiovascular Surgery,Xijing Hospital,Xi＇an 710032,China)
出处
《国际老年医学杂志》
2018年第4期153-156,159,共5页
International Journal of Geriatrics
基金
国家自然科学基金(81470500)
关键词
分泌型卷曲相关蛋白5
冠心病
2型糖尿病
Secreted frizzled - related protein - 5
Coronary heart disease
Type 2 diabetes mellitus
