摘要
目的研究2型糖尿病(T2DM)合并代谢综合征(MS)(T2DM~MS)患者血清补体C1q肿瘤坏死因子相关蛋白(CTRP9)、脂肪型脂肪酸结合蛋白(A-FABP)水平变化及临床意义。方法前瞻性选择2021年1月至2023年12月于广西医科大学第二附属医院治疗的90例T2DM患者纳入研究组,根据是否合并MS将其分为T2DM~MS组(n=71)、T2DM未合并MS组(n=19)。将同期于广西医科大学第二附属医院进行体检的90名健康者纳入对照组。检测并比较研究组与对照组、T2DM~MS组与T2DM未合并MS组的糖脂代谢指标[空腹血糖、高密度脂蛋白(HDL-C)、总胆固醇、低密度脂蛋白(LDL-C)、甘油三酯]及血清CTRP9、A-FABP水平。采用Pearson相关性分析CTRP9、A-FABP与各糖脂代谢指标的相关性;采用受试者操作特征(ROC)曲线评价CTRP9、A-FABP对T2DM~MS的诊断效能。结果研究组的空腹血糖、总胆固醇、LDL-C、甘油三酯及血清A-FABP水平分别为(9.37±0.95)mmol/L、(4.38±0.45)mmol/L、(2.83±0.29)mmol/L、(1.58±0.17)mmol/L、(15.48±1.72)ng/mL,均高于对照组,研究组HDL-C及血清CTRP9水平分别为(1.23±0.14)mmol/L、(8.38±0.85)ng/mL,均低于对照组,差异均有统计学意义(P<0.05)。T2DM~MS组空腹血糖、总胆固醇、LDL-C、甘油三酯及血清A-FABP水平分别为(10.26±1.32)mmol/L、(4.51±0.47)mmol/L、(3.15±0.33)mmol/L、(1.74±0.20)mmol/L、(18.21±2.06)ng/mL,均高于T2DM未合并MS组,T2DM~MS组HDL-C及血清CTRP9水平分别为(1.12±0.13)mmol/L、(7.26±0.75)ng/mL,均低于T2DM未合并MS组,差异均有统计学意义(P<0.05)。经Pearson相关分析,血清CTRP9水平与空腹血糖、总胆固醇、LDL-C、甘油三酯均呈负相关(r=-0.902、-0.780、-0.745、-0.753;均P<0.05),与HDL-C呈正相关(r=0.827,P<0.05);血清A-FABP水平与空腹血糖、总胆固醇、LDL-C、甘油三酯均呈正相关(r=0.843、0.812、0.839、0.722;均P<0.05),与HDL-C呈负相关(r=-0.768,P<0.05)。经ROC曲线分析,血清CTRP9联合A-FABP对T2DM~MS的诊断效能高于两者单独诊断。结论T2DM~MS患者血清CTRP9水平低表达,A-FABP水平高表达,血清CTRP9、A-FABP水平与糖脂代谢指标密切相关。血清CTRP9联合A-FABP可提高T2DM~MS的诊断效能,监测血清CTRP9、A-FABP水平有助于预测T2DM~MS的发生。
Objective To investigate the changes of serum complement C1q tumor necrosis factor-related protein(CTRP9)and adipocyte fatty acid-binding protein(A-FABP)levels and their clinical significance in type 2 diabetes mellitus(T2DM)with metabolic syndrome(MS)(T2DM-MS)patients.Methods Ninety T2DM patients treated in the Second Affiliated Hospital Of Guangxi Medical University from January 2021 to December 2023 were prospectively selected into the study group,and were divided into T2DM to MS group(n=71)and T2DM without MS group(n=19)based on whether to merge MS or not,and 90 healthy people who underwent physical examination in the Second Affiliated Hospital Of Guangxi medical University during the same period were included in the control group.The levels of glucolipid metabolism indexes[fasting blood glucose,high density lipoprotein-cholesterol(HDL-C),total cholesterol,low density lipoprotein-cholesterol(LDL-C),triglyceride],serum CTRP9 and A-FABP were detected and compared between the study group and the control group,T2DM to MS group and T2DM without MS group.The correlation between CTRP9,A-FABP and various glucose and lipid metabolism indicators was analyzed using Pearson correlation analysis.The diagnostic efficacy of CTRP9 and A-FABP for T2DM to MS was evaluated using receiver operating characteristic(ROC)curves.Results The levels of fasting blood glucose,total cholesterol,LDL-C,triglyceride and serum A-FABP in the study group were(9.37±0.95)mmol/L,(4.38±0.45)mmol/L,(2.83±0.29)mmol/L,(1.58±0.17)mmol/L,(15.48±1.72)ng/mL,which were higher than those in the control group,the levels of HDL-C and CTRP9 in the study group were(1.23±0.14)mmol/L and(8.38±0.85)ng/mL,which were lower than those in the control group,the differences were statistically significant(P<0.05).The levels of fasting blood glucose,total cholesterol,LDL-C,triglyceride and serum A-FABP in T2DM to MS group were(10.26±1.32)mmol/L,(4.51±0.47)mmol/L,(3.15±0.33)mmol/L,(1.74±0.20)mmol/L,(18.21±2.06)ng/mL,which were higher than those in T2DM group without MS,the levels of HDL-C and CTRP9 in T2DM to MS group were(1.12±0.13)mmol/L and(7.26±0.75)ng/mL,which were lower than those in T2DM without MS group,the differences were statistically significant(P<0.05).Through Pearson correlation analysis,serum CTRP9 level was negatively correlated with fasting blood glucose,total cholesterol,LDL-C and triglyceride(r=-0.902,-0.780,-0.745,-0.753;P<0.05),and was positively correlated with HDL-C(r=0.827,P<0.05).Serum A-FABP level was positively correlated with fasting blood glucose,total cholesterol,LDL-C and triglyceride(r=0.843,0.812,0.839,0.722;P<0.05),and was negatively correlated with HDL-C(r=-0.768,P<0.05).ROC curve analysis showed that serum CTRP9 combined with A-FABP was more effective in the diagnosis of T2DM-MS than the two alone.Conclusion Serum CTRP9 level in T2DM-MS patients is lower than that in healthy subjects,and A-FABP level is higher than that in healthy subjects.The serum CTRP9 level in T2DM~MS patients is higher than that in T2DM patients without MS,and the serum A-FABP level is lower than that in T2DM patients without MS.Serum CTRP9 and A-FABP levels in T2DM~MS patients are correlated with glucolipid metabolism indexes.Serum CTRP9 combined with A-FABP can improve the diagnostic efficiency of T2DM-MS.
作者
杨柳
韦金梅
林华
黄琳秋
莫丽雯
陆丽莹
廖苑竹
韦秋燕
刘江华
YANG Liu;WEI Jin-mei;LIN Hua(Health Examination Center,The Second Affiliated Hospital Of Guangxi Medical University,Nanning Guangxi 530007,China)
出处
《临床和实验医学杂志》
2024年第13期1400-1403,共4页
Journal of Clinical and Experimental Medicine
基金
广西自然科学基金青年科学基金项目(编号:2023GXNSFBA026100)
广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20200974)。
关键词
2型糖尿病合并代谢综合征
CTRP9
A-FABP
糖脂代谢
Type 2 diabetes mellitus with metabolic syndrome
Complement C1q tumor necrosis factor-related protein
Adipocyte fatty acid-binding protein
Glucolipid metabolism