摘要
目的:探讨血清补体1q/肿瘤坏死因子相关蛋白(CTRP)5、CTRP12、CTRP13与老年2型糖尿病(T2DM)患者糖脂代谢和颈动脉粥样硬化(CAS)的关系。方法:选取2021年1月~2023年1月徐州医科大学附属医院收治的198例老年T2DM患者纳入T2DM组,另选取同期100名体检健康老年人纳入对照组,根据是否CAS将老年T2DM患者分为CAS组131例和非CAS组67例。检测血清CTRP5、CTRP12、CTRP13和糖脂代谢指标[空腹血糖(FPG)、餐后2h血糖(2hBG)、糖化血红蛋白(HbA1c)、稳态模型评估-胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]。采用Pearson相关性分析老年T2DM患者血清CTRP5、CTRP12、CTRP13与糖脂代谢指标水平的相关性,采用多因素Logistic回归模型和受试者工作特征(ROC)曲线分析老年T2DM患者CAS的影响因素及血清CTRP5、CTRP12、CTRP13水平对其的诊断价值。结果:与对照组比较,T2DM组血清CTRP5、FPG、2hBG、HbA1c、HOMA-IR、TC、TG、LDL-C水平升高,CTRP12、CTRP13、HDL-C水平降低(P<0.05)。Pearson相关性分析显示,老年T2DM患者血清CTRP5与FPG、2hBG、HbA1c、HOMA-IR、TC、TG、LDL-C水平呈正相关,与HDL-C水平呈负相关(P<0.05);血清CTRP12、CTRP13与FPG、2hBG、HbA1c、HOMA-IR、TC、TG、LDL-C水平呈负相关,与HDL-C水平呈正相关(P<0.05)。多因素Logistic回归模型分析显示,HbA1c、HOMA-IR、LDL-C、CTRP5升高为老年T2DM患者CAS的独立危险因素,CTRP12、CTRP13升高为独立保护因素(P<0.05)。ROC曲线分析显示,血清CTRP5、CTRP12、CTRP13水平联合诊断老年T2DM患者CAS的曲线下面积(AUC)为0.915,大于血清CTRP5、CTRP12、CTRP13水平单独诊断的0.790、0.785、0.789。结论:老年T2DM患者血清CTRP5水平升高,CTRP12、CTRP13水平降低,与糖脂代谢紊乱和CAS密切相关,血清CTRP5、CTRP12、CTRP13水平联合对老年T2DM患者CAS具有较高的诊断价值。
Objective:To investigate the relationship between serum complement 1q/tumor necrosis factor-related protein(CTRP)5,CTRP12,CTRP13 and glycolipid metabolism and carotid atherosclerosis(CAS)in elderly patients with type 2 diabetes mellitus(T2DM).Methods:198 elderly patients with T2DM who were admitted to The Affiliated Hospital of Xuzhou Medical University from January 2021 to January 2023 were selected as T2DM group,and 100 healthy elderly people during the same period were selected as control group,elderly patients with T2DM were divided into CAS group(n=131)and non-CAS group(n=67)according to whether CAS occurred or not.Serum CTRP5,CTRP12,CTRP13 and glycolipid metabolism indexes[fasting blood glucose(FPG),2 h postprandial blood glucose(2hBG),glycosylated hemoglobin(HbA1c),homeostasis model assessment-insulin resistance index(HOMA-IR),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)]were detected.The correlation between serum CTRP5,CTRP12,CTRP13 and glycolipid metabolism indexes in elderly patients with T2DM were analyzed by Pearson correlation analysis.The influencing factors of CAS in elderly patients with T2DM and the diagnostic value of serum CTRP5,CTRP12 and CTRP13 levels were analyzed by multivariate Logistic regression model and receiver operating characteristic(ROC)curve.Results:Compared with control group,the levels of serum CTRP5,FPG,2hBG,HbA1c,HOMA-IR,TC,TG and LDL-C in T2DM group were increased,and the levels of CTRP12,CTRP13 and HDL-C were decreased(P<0.05).Pearson correlation analysis showed that,serum CTRP5 was positively correlated with FPG,2 hBG,HbA1c,HOMA-IR,TC,TG and LDL-C levels,and negatively correlated with HDL-C level in elderly patients with T2DM(P<0.05).Serum CTRP12 and CTRP13 were negatively correlated with FPG,2hBG,HbA1c,HOMA-IR,TC,TG and LDL-C levels,and positively correlated with HDL-C levels(P<0.05).Multivariate Logistic regression model analysis showed that,elevated HbA1c,HOMA-IR,LDL-C and CTRP5 were independent risk factors for CAS in elderly patients with T2DM,and elevated CTRP12 and CTRP13 were independent protective factors(P<0.05).ROC curve analysis showed that,the area under the curve(AUC)of serum CTRP5,CTRP12 and CTRP13 levels combined in the diagnosis of CAS in elderly patients with T2DM was 0.915,which was greater than 0.790,0.785 and 0.789 of serum CTRP5,CTRP12 and CTRP13 levels alone.Conclusion:The level of serum CTRP5 in elderly patients with T2DM is increase,and the levels of CTRP12 and CTRP13 are decrease,which is closely relate to glycolipid metabolism disorders and CAS,the combination of serum CTRP5,CTRP12 and CTRP13 levels has a high diagnostic value for CAS in elderly patients with T2DM.
作者
孙跃
李志
张钧
刘韬
陈聪
SUN Yue;LI Zhi;ZHANG Jun;LIU Tao;CHEN Cong(The First Clinical Medical College of Xuzhou Medical University,Xuzhou,Jiangsu,221000,China;Department of Geriatric Medicine,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu,221004,China)
出处
《现代生物医学进展》
CAS
2024年第9期1760-1766,共7页
Progress in Modern Biomedicine
基金
江苏省老年健康科研项目(LR2021009)。
