摘要
目的分析甲状腺癌患者血清中chemerin水平与并发糖尿病的相关性,并探究其对甲状腺癌合并糖尿病患者复发的预测价值。方法回顾性选取2016年7月至2019年3月于河南科技大学第一附属医院接受治疗的186例分化型甲状腺癌患者的临床资料,其中无糖尿病并发患者118例(未合并糖尿病组),糖尿病并发患者68例(合并糖尿病组)。比较两组患者的年龄、肿瘤大小、体质量指数(BMI)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)等一般资料,以及血清中chemerin水平及空腹血糖(FPG)、糖化血红蛋白(HbA1c)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)等糖脂类代谢指标;采用Pearson相关分析chemerin水平与糖脂类代谢指标的相关性;采用受试者工作特征曲线(ROC)分析chemerin对甲状腺癌合并糖尿病的诊断价值。结果合并糖尿病组和未合并糖尿病组患者的年龄、肿瘤大小、TSH、FT3比较差异均无统计学意义(P>0.05);合并糖尿病组患者的男性百分比、BMI≥24.99 kg/m2百分比分别为64.71%、80.88%,明显高于未合并糖尿病组的36.44%、37.29%,FT4为(11.28±1.14)pmol/L,明显低于未合并糖尿病组的(11.64±1.21)pmol/L,差异均有统计学意义(P<0.05)。合并糖尿病组患者的血清chemerin、FPG、HbA1c、LDL-C分别为(5.73±1.92)mg/L、(7.67±2.26)mmol/L、(6.43±1.27)%、(2.45±0.35)mmol/L,明显高于未合并糖尿病组的(3.96±0.82)mg/L、(5.12±1.15)mmol/L、(5.26±1.45)%、(2.34±0.29)mmol/L,FT4、HDL-C分别为(11.28±1.14)pmol/L、(1.43±0.39)mmol/L,明显低于未合并糖尿病组的(11.64±1.21)pmol/L、(1.86±0.63)mmol/L,差异均有统计学意义(P<0.05);经Pearson相关分析结果显示,甲状腺癌合并糖尿病患者血清中chemerin水平与FPG、HbA1c、LDL-C呈正相关(r=0.543、0.615、0.623,P<0.05),与HDL-C呈负相关(r=-0.627,P<0.05);经ROC分析结果显示,chemerin诊断甲状腺癌合并糖尿病患者AUC为0.841,截断值为4.826 mg/L,特异性为73.5%,敏感度为89.0%;chemerin预测甲状腺癌合并糖尿病患者复发的AUC为0.933,截断值为5.644 mg/L,此时的特异性为85.6%,敏感度为92.3%。结论chemerin与甲状腺癌合并糖尿病患者糖脂代谢指标存在相关性,chemerin对甲状腺癌并发糖尿病患者复发具有较高的预测价值。
Objective To analyze the correlation between serum chemerin level and diabetes mellitus in patients with thyroid cancer,and to explore its predictive value for recurrence of thyroid cancer complicated with diabetes mellitus.Methods The clinical data of 186 patients with differentiated thyroid cancer treated in the First Affiliated Hospital of Henan University of Science and Technology from July 2016 to March 2019 were retrospectively selected,including 118 patients without diabetes mellitus(non-diabetes mellitus group)and 68 patients with diabetes mellitus(diabetes mellitus group).General data such as age,tumor size,Body Mass Index(BMI),thyroid stimulating hormone(TSH),free triiodothyronine(FT3),and free thyroxine(FT4),and the serum Chemerin level of thyroid cancer patients,as well as glucose and lipid metabolism indicators such as fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C)were compared between the two groups.Pearson correlation was used to analyze the correlation between chemerin levels and glycolipid metabolism indexes.The diagnostic value of chemerin in thyroid cancer complicated with diabetes was analyzed by receiver operating characteristic(ROC)curve.Results There was no significant difference in age,tumor size,TSH,and FT3 between the two groups(P>0.05).The percentage of males and the percentage of BMI≥24.99 kg/m2 in the diabetes mellitus group were 64.71%and 80.88%,respectively,which were significantly higher than 36.44%and 37.29%in the non-diabetes mellitus group,and the FT4 was(11.28±1.14)pmol/L,significantly lower than(11.64±1.21)pmol/L in the non-diabetes mellitus group(P<0.05).The levels of serum chemerin,FPG,HbA1c,and LDL-C in the diabetes mellitus group were(5.73±1.92)mg/L,(7.67±2.26)mmol/L,(6.43±1.27)%,and(2.45±0.35)mmol/L,respectively,which were significantly higher than(3.96±0.82)mg/L,(5.12±1.15)mmol/L,(5.26±1.45)%,and(2.34±0.29)mmol/L in the non-diabetes mellitus group,and the FT4 and HDL-C were(11.28±1.14)pmol/L and(1.43±0.39)mmol/L,respectively,significantly lower than(11.64±1.21)pmol/L and(1.86±0.63)mmol/L in the non-diabetes mellitus group(P<0.05).Pearson correlation analysis showed that serum chemerin level in thyroid cancer patients with diabetes mellitus was positively correlated with FPG,HbA1c,and LDL-C(r=0.543,0.615,0.623,P<0.05),and negatively correlated with HDL-C(r=-0.627,P<0.05).The ROC analysis results showed that the AUC of chemerin in diagnosing thyroid cancer combined with diabetes mellitus was 0.841,the cut-off value was 4.826 mg/L,and the specificity and sensitivity were 73.5%and 89.0%.The AUC of chemerin in predicting the recurrence of thyroid cancer patients with diabetes mellitus was 0.933,the cut-off value was 5.644 mg/L,the specificity was 85.6%,and the sensitivity was 92.3%.Conclusion Chemerin is associated with glycemic and lipid metabolism indexes in patients with thyroid cancer complicated with diabetes mellitus,and chemerin has high predictive value in the recurrence of thyroid cancer complicated with diabete mellitus.
作者
杜红娜
于灿灿
张姗姗
曹慧芳
DU Hong-na;YU Can-can;ZHANG Shan-shan;CAO Hui-fang(Department of Endocrinology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan,CHINA;Department of Gastrointestinal Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan,CHINA)
出处
《海南医学》
CAS
2024年第12期1705-1709,共5页
Hainan Medical Journal
基金
河南省医学科技攻关项目(编号:LHGJ20220438)。
