血清CTRP13和UACR与不稳定型心绞痛合并2型糖尿病的相关性研究  

Relationship between serum CTRP13,UACR levels and unstable angina with type 2 diabetes mellitus

作　　者：李青联 王瑞旭 金凤表[2] 高宇[2] 侯瑞田[1] LI Qinglian;WANG Ruixu;JIN Fengbiao;GAO Yu;HOU Ruitian(Department of Cardiac Electrophysiology,the Affiliated Hospital of Chengde Medical College,Chengde,Hebei 067000,China;Department of Endocrinology,the Affiliated Hospital of Chengde Medical College,Chengde,Hebei 067000,China)

机构地区：[1]承德医学院附属医院心脏电生理科,河北省承德市067000 [2]承德医学院附属医院内分泌科,河北省承德市067000

出　　处：《中国动脉硬化杂志》2022年第4期341-346,共6页Chinese Journal of Arteriosclerosis

基　　金：河北省政府资助专科能力建设和专科带头人培养(2018361008);河北省医学科学研究课题计划(20200180)。

摘　　要：目的探讨血清补体C1q/肿瘤坏死因子相关蛋白13(CTRP13)及尿微量白蛋白/肌酐比值(UACR)与不稳定型心绞痛(UAP)合并2型糖尿病(T2DM)的关系。方法选取2019年10月—2020年10月在承德医学院附属医院心内科和内分泌科住院的150例患者,根据是否诊断UAP和T2DM分为UAP+T2DM组(n=50)、UAP组(n=50)和T2DM组(n=50),选取同期体检的健康人为对照组(n=50)。分别测定四组患者的血清CTRP13浓度和晨尿UACR水平。比较各组间的一般资料及CTRP13和UACR水平的差异,分析UAP+T2DM组CTRP13和UACR与各指标的相关性;使用倒数f[CTRP13(ng/L)]=1/[CTRP13(ng/L)]转换CTRP13(ng/L),用ROC曲线分析f(CTRP13)和UACR单独检测及联合检测对UAP+T2DM的预测效能。结果血清CTRP13水平在UAP+T2DM组最低,T2DM组和UAP组次之,对照组水平最高(P<0.05);UACR水平在UAP+T2DM组最高,UAP组和T2DM组次之,对照组最低(P<0.05)。UAP+T2DM组Gensini评分高于UAP组(P<0.05)。相关性分析显示,在UAP+T2DM组,血清CTRP13水平与空腹血糖(FPG)、高敏C反应蛋白(hs-CRP)及Gensini评分呈负相关,与高密度脂蛋白胆固醇(HDLC)呈正相关(均P<0.05);UACR与腰围、低密度脂蛋白胆固醇(LDLC)、hs-CRP及Gensini评分呈正相关(均P<0.05)。ROC曲线显示,f(CTRP13)、UACR单独检测及联合检测预测UAP合并T2DM的曲线下面积(AUC)分别为0.820(95%CI:0.759~0.882)、0.846(95%CI:0.786~0.905)和0.876(95%CI:0.820~0.931),其灵敏度分别为88%、82%和86%,其特异度分别为64%、80%和77.3%。结论CTRP13和UACR不仅可作为UAP合并T2DM患者临床诊断的辅助指标,还可用于评估冠状动脉病变的严重程度;二者联合检测对UAP合并T2DM的诊断价值更高。Aim To investigate the relationship between complement-C1q/TNF-related protein 13(CTRP13),urinary microalbumin/creatinine ratio(UACR)and unstable angina pectoris(UAP)with type 2 diabetes(T2DM).Methods From October 2019 to October 2020,150 patients who were hospitalized in the Department of Cardiology and Endocrinology of the Affiliated Hospital of Chengde Medical College were divided into UAP+T2DM group(n=50),UAP group(n=50)and T2DM group(n=50)according to whether they were diagnosed with UAP and T2DM.Healthy people who underwent physical examination at the same time were selected as the control group(n=50).Serum CTRP13 concentration and morning urine UACR level were measured in four groups.The general data and the differences of CTRP13 and UACR levels were compared among groups,and the correlation between CTRP13,UACR and various indexes was analyzed in UAP+T2DM group;The reciprocal f(CTRP13(ng/L))=1/(CTRP13(ng/L))was used to convert CTRP13.The predictive efficacy of f(CTRP13)and UACR on UAP+T2DM was analyzed by ROC curve.Results The level of serum CTRP13 was the lowest in UAP+T2DM group,followed by T2DM group and UAP group,and the highest in control group(P<0.05).The level of UACR was the highest in UAP+T2DM group,followed by UAP group and T2DM group,and the lowest in control group(P<0.05).The Gensini score of UAP+T2DM group was higher than that of UAP group.Correlation analysis showed that in UAP+T2DM group,the level of serum CTRP13 was negatively correlated with fasting blood glucose(FPG),high sensitivity C-reactive protein(hs-CRP)and Gensini score,and positively correlated with high density lipoprotein cholesterol(HDLC)(all P<0.05);UACR was positively correlated with waist circumference,low density lipoprotein cholesterol(LDLC),hs-CRP and Gensini score(all P<0.05).The ROC curve showed that the areas under the curve(AUC)of f(CTRP13)and UACR single detection and combined detection of UAP combined with T2DM were 0.820(95%CI:0.759~0.882),0.846(95%CI:0.786~0.905)and 0.876(95%CI:0.820~0.931)respectively;their sensi

关 键 词：补体C1q/肿瘤坏死因子相关蛋白13 尿微量白蛋白/肌酐比值 不稳定型心绞痛 2型糖尿病 

分 类 号：R5[医药卫生—内科学]