血清GGT、SFRP-5、AHSG/APN比值在2型糖尿病合并代谢综合征患者中的意义  

Significance of GGT,SFRP-5 and AHSG/APN ratio in patients with type 2 diabetes mellitus complicating metabolic syndrome

作　　者：李晶 葛旭辉 LI Jing;GE Xuhui(Department of Endocrinology,Xidian Group Hospital,Xi′an,Shaanxi 710000,China;Comprehensive Wards,Xianyang Municipal Maternal and Child Health Care Hospital,Xianyang,Shaanxi 712000,China)

机构地区：[1]西电集团医院内分泌科,陕西西安710000 [2]陕西省咸阳市妇幼保健院综合病区,陕西咸阳712000

出　　处：《检验医学与临床》2023年第18期2676-2681,共6页Laboratory Medicine and Clinic

基　　金：陕西省科技厅创新能力支撑计划项目(2018ZC375)。

摘　　要：目的探讨血清γ-谷氨酰转肽酶(GGT)、分泌型卷曲相关蛋白5(SFRP-5)、胎球蛋白A/脂联素(AHSG/APN)比值在2型糖尿病(T2DM)合并代谢综合征(MS)患者中的临床意义。方法选取2021年6月至2022年6月西电集团医院收治的120例T2DM患者为研究对象,根据患者是否合并MS将患者分为MS组和非MS组,检测对比两组患者的GGT、SFRP-5、AHSG/APN比值、肥胖体表测量指标、糖脂代谢指标和胰岛素抵抗指标。采用Pearson相关分析T2DM合并MS患者的GGT、SFRP-5、AHSG/APN比值与肥胖体表测量指标、糖脂代谢指标和胰岛素抵抗指标的相关性。采用多因素Logistic回归分析T2DM合并MS的危险因素。采用受试者工作特征(ROC)曲线分析部分指标对T2DM合并MS发病的预测价值。结果T2DM患者合并MS 68例(MS组),T2DM患者未合并MS 52例(非MS组)。MS组体质量指数(BMI)、腰围(WC)、腰臀比(WHR)均大于非MS组(P<0.05),血清SFRP-5、高密度脂蛋白胆固醇(HDL-C)水平低于非MS组(P<0.05),血清GGT、AHSG/APN比值、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)水平均高于非MS组(P<0.05)。SFRP-5与BMI、WHR、FBG、2 hPBG、HOMA-IR、HOMA-β、TC、TG、LDL-C呈负相关(P<0.05),与HDL-C呈正相关(P<0.05);GGT、AHSG/APN比值与BMI、WC、WHR、FBG、2 hPBG、HOMA-IR、HOMA-β、TC、TG、LDL-C呈正相关(P<0.05),与HDL-C呈负相关(P<0.05)。多因素Logistic回归分析,GGT≥58.66 U/L、AHSG/APN比值≥40.55%是T2DM合并MS的独立危险因素(P<0.05),SFRP-5≥90.28 ng/L是T2DM合并MS的保护因素(P<0.05)。ROC曲线分析显示,GGT、SFRP-5、AHSG/APN比值单项及3项联合预测T2DM合并MS发病的曲线下面积(AUC)分别为0.724(95%CI:0.519~0.926)、0.770(95%CI:0.595~0.932)、0.731(95%CI:0.513~0.947)、0.893(95%CI:0.797~0.955),3项指标联合应用的预测效能高于单项指标。结论T2DM合并MS患者Objective To investigate the clinical significance ofγ-glutamyltranspeptidase(GGT),secretory crimp associated protein 5(SFRP-5)and alpha2-heremans-schmid glycoprotein/adiponectin(AHSG/APN)ratio in the patients with type 2 diabetes mellitus(T2DM)complicating metabolic syndrome(MS).Methods A total of 120 cases of T2DM admitted and treated in this hospital from June 2021 to June 2022 were selected as the study subjects and divided into the MS group and non-MS group according to whether complicating MS.GGT,SFRP-5,AHSG/APN ratio,obesity body surface measurement indexes,glucose and lipid metabolism indexes and insulin resistance indexes were detected and compared between the two groups.The Pearson correlation was used to analyze the correlations between GGT,SFRP-5 and AHSG/APN ratio with the body surface measurement indexes,glucose and lipid metabolism indexes and insulin resistance indexes of obesity in the patients with T2DM complicating MS.The multivariate Logistic regression was used to analyze the risk factors in the patients with T2DM complicating MS.The receiver operating characteristic(ROC)curve was used to analyze the value of partial indexes for predicting the onset of T2DM complicating MS.Results There were 68 cases of T2DM complicating MS(MS group)and 52 cases of T2DM without complicating MS(non-MS group).Body mass index(BMI),waist circumference(WC)and waist-to-hip ratio(WHR)in the MS group were all greater than those in the non-MS group(P<0.05);serum SFRP-5 and high density lipoprotein cholesterol(HDL-C)levels were lower than those in non-MS group(P<0.05);Serum GGT,AHSG/APN ratio,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),and fasting blood glucose(FBG),2 h postpranpranal blood glucose(2 hPBG),insulin resistance index(HOMA-IR),and isletβcell function index(HOMA-β)levels were higher than those in non-MS group(P<0.05).SFRP-5 was negatively correlated with BMI,WC,WHR,FBG,2 hPBG,HOMA-IR,HOMA-β,TC,TG and LDL-C(P<0.05),and positive correlated with HDL-C(P<0.05).GGT and A

关 键 词：2型糖尿病 代谢综合征 Γ-谷氨酰转肽酶 分泌型卷曲相关蛋白5 胎球蛋白A/脂联素比值 

分 类 号：R587.1[医药卫生—内分泌]