In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic indiv...In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic individuals. Diabetes is a complex and multifactorial disease involving genetic components. With the aim of preventing complications and contributing to an efficient management of diabetes, we investigated genes likely to lead to a risk of thrombosis, in particular the C677T of MTHFR, G20210A of prothrombin, and R506Q of factor V Leiden in type 2 diabetics in Abidjan receiving ambulatory care. A descriptive cross-sectional study was carried out on consenting type 2 diabetic patients. Mutation detection was carried out using the PCR-RFLP method employing restriction enzymes. Hemostasis tests (fibrinogen, D-dimers, fibrin monomers, and von Willebrand factor) were performed using citrate tubes on the Stage? Star Max automated system. Plasminogen activator inhibitor was assayed by ELISA method, and biochemical parameters were determined using the COBAS C311. The study population consisted of 45 diabetic patients, 51.1% of whom presented vascular complications, mainly neuropathy. Disturbances in hemostasis parameters were observed, with 15.5% of patients showing an increase in fibrin monomers. Mutation analysis revealed an absence of factor V mutation (factor V Leiden) and of G20210A mutation of the prothrombin gene. However, 15.6% of subjects had a heterozygous C677T mutation of MTHFR, with 57% of them being anemic. The exploration of biological and genetic factors associated with thrombotic risk is of significant interest in the optimal management of African type 2 diabetics.展开更多
目的探讨血清丛生蛋白(Clusterin)及趋化因子受体5(CCR5)在慢加急性肝衰竭(acute-on-chronic liver failure,ACLF)患者中的表达以及两者联合检测对ACLF患者预后的预测价值。方法选取2018年1月~2020年12月唐山市传染病医院收治的84例ACL...目的探讨血清丛生蛋白(Clusterin)及趋化因子受体5(CCR5)在慢加急性肝衰竭(acute-on-chronic liver failure,ACLF)患者中的表达以及两者联合检测对ACLF患者预后的预测价值。方法选取2018年1月~2020年12月唐山市传染病医院收治的84例ACLF患者作为观察组,同期选择在该院体检的80例健康体检者作为对照组。采用酶联免疫吸附试验(ELISA)法测定患者血清中Clusterin和CCR5水平;根据患者预后28天情况,将其分为存活组(n=48)和死亡组(n=36)。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血清Clusterin与CCR5联合检测对ACLF患者预后的预测价值;Spearman相关性分析血清Clusterin和CCR5水平与终末期肝病模型(model for end-stage liver disease,MELD)评分、慢性肝衰竭-序贯器官衰竭评分(chronic liver failure-sequential organ failure assessment,CLIF-SOFA)的相关性;采用多因素Logistic回归分析ACLF患者预后的影响因素。结果与对照组相比,观察组Clusterin(87.37±9.99μg/ml vs 104.85±15.14μg/ml)及CCR5(11.55±2.86μg/ml vs 15.68±3.01μg/ml)水平降低,差异具有统计学意义(t=8.767,9.010,均P<0.05)。与存活组相比,死亡组Clusterin(77.40±9.26μg/ml vs94.85±10.54μg/ml)及CCR5(8.58±1.98μg/ml vs 13.78±3.52μg/ml)水平降低,差异具有统计学意义(t=7.904,7.962,均P<0.05)。ROC曲线显示,血清Clusterin与CCR5联合预测的曲线下面积(area under curve,AUC)(0.927)最大,其敏感度和特异度分别为88.90%和83.30%。经Spearman相关性分析Clusterin与MELD,CLIF-SOFA评分呈负相关(r=-0.524,-0.457,均P<0.05),CCR5与MELD,CLIF-SOFA评分呈负相关(r=-0.611,-0.358,均P<0.05)。多因素Logistic回归分析显示,血清Clusterin,CCR5及IL-6为ACLF患者预后不良的影响因素(均P<0.05)。结论Clusterin及CCR5在ACLF患者血清中表达下调,且联合检测二者在预测ACLF患者短期预后方面具有良好的参考价值。展开更多
文摘In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic individuals. Diabetes is a complex and multifactorial disease involving genetic components. With the aim of preventing complications and contributing to an efficient management of diabetes, we investigated genes likely to lead to a risk of thrombosis, in particular the C677T of MTHFR, G20210A of prothrombin, and R506Q of factor V Leiden in type 2 diabetics in Abidjan receiving ambulatory care. A descriptive cross-sectional study was carried out on consenting type 2 diabetic patients. Mutation detection was carried out using the PCR-RFLP method employing restriction enzymes. Hemostasis tests (fibrinogen, D-dimers, fibrin monomers, and von Willebrand factor) were performed using citrate tubes on the Stage? Star Max automated system. Plasminogen activator inhibitor was assayed by ELISA method, and biochemical parameters were determined using the COBAS C311. The study population consisted of 45 diabetic patients, 51.1% of whom presented vascular complications, mainly neuropathy. Disturbances in hemostasis parameters were observed, with 15.5% of patients showing an increase in fibrin monomers. Mutation analysis revealed an absence of factor V mutation (factor V Leiden) and of G20210A mutation of the prothrombin gene. However, 15.6% of subjects had a heterozygous C677T mutation of MTHFR, with 57% of them being anemic. The exploration of biological and genetic factors associated with thrombotic risk is of significant interest in the optimal management of African type 2 diabetics.
文摘目的探讨血清丛生蛋白(Clusterin)及趋化因子受体5(CCR5)在慢加急性肝衰竭(acute-on-chronic liver failure,ACLF)患者中的表达以及两者联合检测对ACLF患者预后的预测价值。方法选取2018年1月~2020年12月唐山市传染病医院收治的84例ACLF患者作为观察组,同期选择在该院体检的80例健康体检者作为对照组。采用酶联免疫吸附试验(ELISA)法测定患者血清中Clusterin和CCR5水平;根据患者预后28天情况,将其分为存活组(n=48)和死亡组(n=36)。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血清Clusterin与CCR5联合检测对ACLF患者预后的预测价值;Spearman相关性分析血清Clusterin和CCR5水平与终末期肝病模型(model for end-stage liver disease,MELD)评分、慢性肝衰竭-序贯器官衰竭评分(chronic liver failure-sequential organ failure assessment,CLIF-SOFA)的相关性;采用多因素Logistic回归分析ACLF患者预后的影响因素。结果与对照组相比,观察组Clusterin(87.37±9.99μg/ml vs 104.85±15.14μg/ml)及CCR5(11.55±2.86μg/ml vs 15.68±3.01μg/ml)水平降低,差异具有统计学意义(t=8.767,9.010,均P<0.05)。与存活组相比,死亡组Clusterin(77.40±9.26μg/ml vs94.85±10.54μg/ml)及CCR5(8.58±1.98μg/ml vs 13.78±3.52μg/ml)水平降低,差异具有统计学意义(t=7.904,7.962,均P<0.05)。ROC曲线显示,血清Clusterin与CCR5联合预测的曲线下面积(area under curve,AUC)(0.927)最大,其敏感度和特异度分别为88.90%和83.30%。经Spearman相关性分析Clusterin与MELD,CLIF-SOFA评分呈负相关(r=-0.524,-0.457,均P<0.05),CCR5与MELD,CLIF-SOFA评分呈负相关(r=-0.611,-0.358,均P<0.05)。多因素Logistic回归分析显示,血清Clusterin,CCR5及IL-6为ACLF患者预后不良的影响因素(均P<0.05)。结论Clusterin及CCR5在ACLF患者血清中表达下调,且联合检测二者在预测ACLF患者短期预后方面具有良好的参考价值。
