糖尿病肾病患者血清ICAM-1 VCAM-1及CTRP9表达水平与冠脉血管钙化的关系  

Association of Serum ICAM-1 VCAM-1 and CTRP9 Expression Levels with Coronary Vascular Calcification in Patients with Diabetic Nephropathy

作　　者：侯睿 胡炜 董佩[1] 胡大军[1] HOU Rui;HU Wei;DONG Pei(The Second People's Hospital of Three Gorges University,Hubei Yichang 443000,China)

机构地区：[1]三峡大学第二人民医院肾内科,湖北宜昌443000

出　　处：《河北医学》2022年第8期1279-1285,共7页Hebei Medicine

基　　金：2021年度湖北省教育厅科学研究计划资助项目,(编号:Q20211206)。

摘　　要：目的:探究糖尿病肾病(DKD)患者血清细胞间粘附分子-1(ICAM-1)、血管细胞粘附分子-1(VCAM-1)、补体C1q肿瘤坏死因子相关蛋白9(CTRP9)表达水平与冠状动脉血管钙化关系。方法:选取2019年5月至2021年10月152例DKD患者,根据是否合并冠脉血管钙化分为钙化组68例、非钙化组84例。比较两组一般资料、相关生化指标及血清ICAM-1、VCAM-1、CTRP9水平(酶联免疫吸附试验法);采用多因素Logistic回归分析探究DKD冠脉血管钙化影响因素,绘制ROC曲线探究血清ICAM-1、VCAM-1、CTRP9水平对DKD血管钙化预测价值。结果:钙化组中DKD临床期占比高于非钙化组(P<0.05),但两组性别、年龄、体重指数、吸烟史、饮酒史、糖尿病病程比较差异均无统计学意义(P>0.05);钙化组HbA1c、LDL-C、血钙、m Alb水平均较非钙化组升高(P<0.05),但两组TG、TC、HDL-C、血磷、BUN、SCr水平比较差异均无统计学意义(P>0.05);钙化组血清ICAM-1、VCAM-1水平均显著高于非钙化组(P<0.05),CTRP9水平显著低于非钙化组(P<0.05);DKD临床期、HbA1c水平高、ICAM-1水平高、VCAM-1水平高均是影响DKD患者冠脉血管钙化的危险因素(P<0.05),CTRP9水平高是其保护因素(P<0.05);血清ICAM-1、VCAM-1、CTRP9预测DKD冠脉血管钙化的ROC曲线下面积分别为0.710、0.761、0.752(P<0.05)。结论:DKD伴冠脉血管钙化者血清ICAM-1、VCAM-1表达升高,CTRP9表达下降,检测三者水平对DKD冠脉血管钙化有一定预测价值。Objective:To explore the association of the expression levels of serum intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1)and complement C1q tumor necrosis factor related protein 9(CTRP9)with coronary vascular calcification in patients with diabetic kidney disease(DKD).Methods:Totally 152 patients with DKD were selected between May 2019 and October 2021,and were divided into calcification group(68 cases)and non-calcification group(84 cases)according to whether they were complicated with coronary calcification.The general data,related biochemical indicators and levels of serum ICAM-1,VCAM-1 and CTRP9(measured by enzyme-linked immunosorbent assay)were compared between the two groups.Multivariate Logistic regression analysis was used to explore the influencing factors of coronary vascular calcification in DKD,and ROC curves were plotted to explore predictive value of serum ICAM-1,VCAM-1 and CTRP9 levels on vascular calcification in DKD.Results:The proportion of DKD clinical stage in calcification group was higher than that in non-calcification group(P<0.05),but there were no statistical differences in gender,age,body mass index,smoking history,drinking history and duration of diabetes mellitus between the two groups(P>0.05).The levels of HbA1c,LDL-C,blood calcium and m Alb were higher in calcification group than in non-calcification group(P<0.05),but the differences in the levels of TG,TC,HDL-C,blood phosphorus,BUN and SCr were not statistically significant between the two groups(P>0.05).Serum ICAM-1 and VCAM-1 levels in calcification group were significantly higher than those in non-calcification group(P<0.05),while the CTRP9 level was significantly lower than that in the non-calcification group(P<0.05).Clinical stage of DKD and high levels of HbA1c,ICAM-1 and VCAM-1 were the risk factors for coronary vascular calcification in patients with DKD(P<0.05),and high level of CTRP9 was a protective factor(P<0.05).The areas under the ROC curves of serum ICAM-1,VCAM-1 and CTRP9 on predicting

关 键 词：糖尿病肾病 冠脉血管钙化 细胞间粘附分子-1 血管细胞粘附分子-1 补体C1q肿瘤坏死因子相关蛋白9 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]