摘要
目的探讨血脂、血清胰岛素样生长因子1(IGF-1)水平与2型糖尿病患者微血管病变的相关性。方法选取2021年1月-2022年10月于淮南朝阳医院确诊的40例发生微血管病变的2型糖尿病患者作为观察组,及同期诊治的40例无微血管病变的2型糖尿病患者作为对照组。采用酶联免疫吸附(ELISA)法检测2型糖尿病患者血清中IGF-1的水平;使用全自动生化分析仪测定总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平;Spearman法分析2型糖尿病患者TC、TG、LDL-C、HDL-C、IGF-1水平与微血管病变的相关性;logistic回归分析影响2型糖尿病患者发生微血管病变的因素;受试者工作特征(ROC)曲线分析血脂、血清IGF-1水平对2型糖尿病患者发生微血管病变的诊断价值。结果观察组患者TC、TG、LDL-C、IGF-1水平分别为(5.86±0.77)mmol/L、(2.64±0.86)mmol/L、(3.81±0.76)mmol/L和(36.79±5.13)mg/L,均显著高于对照组(5.12±0.64)mmol/L、(1.96±0.61)mmol/L、(3.14±0.72)mmol/L和(29.43±4.58)mg/L;HDL-C水平为(1.11±0.35)mmol/L,显著低于对照组(1.42±0.40)mmol/L;差异均有统计学意义(t=4.674、4.079、4.048、6.769、3.689,P均<0.001)。2型糖尿病患者微血管病变与TC、TG、LDL-C、IGF-1水平成正相关(r=0.525、0.478、0.454、0.617,P均<0.001),与HDL-C水平成负相关(r=-0.446,P<0.001)。Logistic回归分析发现,病程、糖化血红蛋白(HbAlc)、TC、TG、LDL-C、IGF-1是影响2型糖尿病患者发生微血管病变的危险因素(OR=4.561、1.984、5.291、3.370、2.517、1.388,P均<0.05),饮酒、HDL-C是影响2型糖尿病患者发生微血管病变的保护因素(OR=0.422、0.100,P均<0.05)。TC、TG、LDL-C、HDL-C、IGF-1联合检测诊断2型糖尿病患者发生微血管病变的曲线下面积(AUC)为0.954,均优于TC、TG、LDL-C、HDL-C、IGF-1单独诊断的0.789、0.752、0.710、0.692、0.851,差异均有统计学意义(Z=6.579、7.251、8.474、9.100、4.606,P均<0.001)。结论2型糖尿病微血管病变患者TC、TG、LDL-C、IGF-1水平升高,HDL-C水平下降,联合检测可较好地对2型糖尿病患者微血管病变进行诊断。
Objective To investigate the relationships between blood lipid,serum insulin-like growth factor 1(IGF-1)levels and microangiopathy in type 2 diabetes mellitus patients.Methods A total of 40 type 2 diabetes mellitus patients with microangiopathy diagnosed in the Huainan Chaoyang Hospital from January 2021 to October 2022 were selected as the observation group,and 40 type 2 diabetes mellitus patients without microangiopathy diagnosed and treated at the same time were taken as the control group.The level of IGF-1 in serum of type 2 diabetes mellitus patients was detected by enzyme-linked immunosorbent assay(ELISA);the levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)were measured by automatic biochemical analyzer;Spearman method was used to analyze the correlations between the levels of TC,TG,LDL-C,HDL-C,IGF-1 and microangiopathy in type 2 diabetes mellitus patients;logistic regression analysis was used to analyze the factors influencing microangiopathy in type 2 diabetes mellitus patients;the diagnostic value of blood lipid and serum IGF-1 level for microangiopathy in type 2 diabetes mellitus patients was analyzed by receiver operating characteristic(ROC)curve.Results The levels of TC,TG,LDL-C and IGF-1 in the observation group were(5.86±0.77)mmol/L,(2.64±0.86)mmol/L,(3.81±0.76)mmol/L and(36.79±5.13)mg/L,respectively,which were obviously higher than those in the control group[(5.12±0.64)mmol/L,(1.96±0.61)mmol/L,(3.14±0.72)mmol/L and(29.43±4.58)mg/L];the level of HDL-C was(1.11±0.35)mmol/L,which was obviously lower than that of the control group[(1.42±0.40)mmol/L];the differences were statistically significant(t=4.674,4.079,4.048,6.769,3.689;P all<0.001).Microangiopathy in type 2 diabetes mellitus patients was positively correlated with TC,TG,LDL-C,IGF-1 levels(r=0.525,0.478,0.454,0.617;P all<0.001),and was negatively correlated with HDL-C level(r=-0.446,P<0.001).Logistic regression analysis found that the course of disease,glycosylated hemoglobin(HbAlc),TC,TG,LDL-C and IGF-1 were risk factors for microangiopathy in type 2 diabetes mellitus patients(OR=4.561,1.984,5.291,3.370,2.517,1.388;P all<0.05);alcohol consumption and HDL-C were protective factors for microangiopathy in type 2 diabetes mellitus patients(OR=0.422,0.100;P all<0.05).The area under curve(AUC)of the combined detection of TC,TG,LDL-C,HDL-C,IGF-1 in the diagnosis of microangiopathy in type 2 diabetes mellitus patients was 0.954,and was better than TC,TG,LDL-C,HDL-C,IGF-1 alone(0.789,0.752,0.710,0.692,0.851);the differences were statistically significant(Z=6.579,7.251,8.474,9.100,4.606;P all<0.001).Conclusions The levels of TC,TG,LDL-C and IGF-1 in patients with microangiopathy of type 2 diabetes mellitus increased,while the level of HDL-C decreased.The diagnostic value of using the combination of TC,TG,LDL-C,HDL-C and IGF-1 for microangiopathy in type 2 diabetes mellitus patients was higher than using any single factor.
作者
蔡传元
刘妮娜
CAI Chuanyuan;LIU Nina(Department of Endocrinology,Huainan Chaoyang Hospital,Huainan,Anhui 232007,China;Department of Endocrinology,the Second Hospital of Anhui Medical University,Hefei,Anhui 230601,China)
出处
《热带医学杂志》
CAS
2023年第6期833-837,888,共6页
Journal of Tropical Medicine
基金
安徽高校科学研究项目(KJ2021A0319)
