2型糖尿病患者血清LTB4水平与心血管自主神经病变的关系  

Relationship between serum LTB4 level and cardiovascular autonomic neuropathy in type 2 diabetes mellitus

作　　者：阚春婷 张瑛 曹长春 KAN Chunting;ZHANG Ying;CAO Changchun(Department of Endocrine Gulou Hospital Group Suqian Hospital/Suqian Hospital Affiliated to Xuzhou Medical University,Suqian,Jiangsu 223800,China)

机构地区：[1]南京鼓楼医院集团宿迁医院/徐州医科大学附属宿迁医院内分泌科,江苏宿迁223800

出　　处：《国际检验医学杂志》2023年第2期196-199,204,共5页International Journal of Laboratory Medicine

基　　金：江苏省“六大人才高峰”高层次人才选拔培养项目(YY-047);宿迁市科技计划项目(Z2019160);2019年度市级指导性科技计划项目(Z2019169)。

摘　　要：目的分析2型糖尿病(T2DM)患者血清白三烯B4(LTB4)水平与心血管自主神经病变(CAN)的关系。方法采用前瞻性队列观察的方法,选择2020年2月至2022年2月该院确诊的T2DM患者共408例作为研究对象,入院根据标准心血管自主神经反射试验(CARTs)分为无CAN组276例和CAN组132例,比较两组患者的临床资料和血生化指标。然后根据LTB4水平中位数分为低LTB4组204例和高LTB4组204例。分析LTB4水平与CARTs参数的相关性。多因素Logistic回归分析筛选CAN的危险因素。最后采用受试者工作特征(ROC)曲线计算LTB4预测CAN的曲线下面积(AUC)。结果CAN组血清LTB4水平明显高于无CAN组,差异有统计学意义(P<0.001)。高LTB4组卧-立收缩压差和CAN发生率比低LTB4组增加,差异有统计学意义(P<0.05),而深呼吸心率差值、Valsalva R-R比值、立-卧心率差值比低LTB4组降低,差异有统计学意义(P<0.05)。Pearson相关结果显示,LTB4与卧-立收缩压差呈正相关(r=0.597,P<0.001),与深呼吸心率差值、Valsalva R-R比值和立-卧心率差值呈负相关(r=-0.502、-0.568、-0.613,P<0.001)。多因素Logistic回归分析显示,LTB4水平升高是CAN发生的独立危险因素(OR=3.265,P<0.001)。ROC曲线计算LTB4水平预测CAN的AUC为0.876(P<0.001)。结论T2DM患者血清LTB4水平升高与CAN发生密切相关,有望成为临床诊断CAN的重要新型标志物。Objective To analyze the relationship between serum leukotriene B4(LTB4)level and cardiovascular autonomic neuropathy(CAN)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 408 patients with T2DM diagnosis into hospital from February 2020 to February 2022 were enrolled as the research objects in the prospective cohort observation study.They were divided into non-CAN group(n=276)and CAN group(n=132)according to the standard cardiovascular autonomic reflex test(CARTs).The clinical datas and blood biochemical indexes between the two groups were compared.Then,204 patients were divided into low-LTB4 group and 204 patients were into high-LTB4 group according to the median LTB4 value.The correlation between LTB4 level and CARTs parameters were analyzed.Multivariate Logistic regression analysis was used to screen the risk factors of CAN.Finally,the area under the curve(AUC)of LTB4 for predicting CAN was calculated by receiver operating curve(ROC).Results The level of serum LTB4 in CAN group was significantly higher than that in non-CAN group,the difference was statistically significant(P<0.001).The horizontal-vertical systolic pressure difference and CAN rate in the high-LTB4 group were significantly higher than those in the low-LTB4 Group,the difference was statistically significant(P<0.05),while the deep breathing heart rate difference,Valsalva R-R ratio and standing-lying heart rate difference were significantly lower than those in the low-LTB4 group,the difference was statistically significant(P<0.05).Pearson test showed that LTB4 was significantly positively correlated with horizontal-vertical systolic pressure difference(r=0.597,P<0.001),and negatively correlated with deep breathing heart rate difference,Valsalva R-R ratio and standing-lying heart rate difference(r=-0.502,-0.568,-0.613,P<0.001).Multiva riate Logistic regression analysis showed that higher LTB4 was the independent risk factor to CAN(OR=3.265,P<0.001).ROC calculated the AUC of LTB4 level for predicting CAN was 0.876(P<0.001).Conclusio

关 键 词：2型糖尿病 白三烯B4 心血管自主神经病变 标志物 

分 类 号：R587.1[医药卫生—内分泌]