2型糖尿病合并冠心病患者TIMP-4、FFA水平和EAT厚度与颈部血管病变相关性分析  

Correlation of TIMP-4,FFA and EAT Thickness with Cervical Vascular Disease in Patients with Type 2 Diabetes Mellitus and Coronary Heart Disease

作　　者：王博[1] WANG Bo(Department of Cardiovascular Medicine,the First Affiliated Hospital,Xi'an Shaanxi 710002)

机构地区：[1]西安市第一医院心血管内科,陕西西安710002

出　　处：《医学临床研究》2023年第9期1331-1334,共4页Journal of Clinical Research

摘　　要：【目的】探讨2型糖尿病(T2DM)合并冠心病(CHD)患者组织型金属蛋白酶抑制剂4(TIMP-4)、游离脂肪酸(FFA)水平及心外膜脂肪组织(EAT)厚度与颈部血管病变相关性。【方法】选取2019年5月至2022年5月在本院行冠脉造影检查诊断为T2DM合并CHD的158例患者,根据是否存在颈部血管病变分为非颈部血管病变组(n=90)、颈部血管病变组(n=68)。收集并比较两组患者临床资料;采用酶联免疫吸附法(ELSA)检测两组患者血清TIMP-4、FFA水平;使用超声心动图测量EAT厚度;采用多因素Logistic回归分析T2DM合并CHD患者发生颈部血管病变的危险因素;采用受试者工作特征(ROC)曲线评估血清TIMP-4、FFA水平及EAT厚度对T2DM合并CHD患者发生颈部血管病变的诊断价值。【结果】与非颈部血管病变组比较,颈部血管病变组患者血清TIMP-4水平降低(P<0.05),FFA水平及EAT厚度升高(P<0.05);多因素Logistic回归分析显示:TIMP-4水平降低、FFA水平及EAT厚度升高是T2DM合并CHD颈部血管病变的危险因素(OR=3.968、2.587、4.125,均P<0.05);血清TIMP-4、FFA水平及EAT厚度联合诊断T2DM合并CHD患者发生颈部血管病变的AUC分别为0.753、0.506、0.856、0.915,灵敏度分别为83.10%、70.69%、83.1%、85.77%,特异度分别为85.60%、62.87%、89.6%、82.96%。【结论】血清TIMP-4、FFA水平及EAT厚度联合检测对T2DM合并CHD患者发生颈部血管病变有一定的诊断价值,可为临床早期诊治T2DM合并CHD颈部血管病变提供一定参考。【Objective】To investigate the relationship of tissue type metal Protease inhibitor 4(TIMP-4),Free Fatty Acid(FFA)and thickness of epicardial adipose tissue(EAT)with cervical vascular disease in patients with type 2 diabetes Mellitus(T2DM)and coronary heart disease(CHD).【Methods】From May 2019 to May 2022,158 patients with T2DM and CHD who underwent coronary angiography in our hospital were selected and divided into two groups:non-cervical vascular disease group(n=90)and cervical vascular disease group(n=68).The clinical data of the two groups of patients were collected and compared between the two groups.The Serum Levels of Timp-4 and FFA were measured by Elisa,and the thickness of EAT was measured by echocardiography.Multivariate Logistic regression was used to analyze the risk factors of cervical vascular disease in T2DM patients with CHD.The diagnostic value of serum levels of TIMP-4,FFA and EAT thickness in patients with T2DM complicated with CHD cervical vascular disease was evaluated by ROC.【Results】Compared with the non-cervical vascular disease group,the serum level of TIMP-4 decreased(P<0.05),while the FFA level and the thickness of EAT increased(P<0.05).Multiple Logistic regression analysis showed that the decreased level of TIMP-4,the increased level of FFA and the thickness of EAT were the risk factors of cervical vascular disease in T2DM patients with CHD(OR=3.968,2.587,and 4.125,respectively,P<0.05).The AUC of serum TIMP-4,FFA and EAT thickness alone and the combination of the three detections in the diagnosis of cervical vascular disease in T2DM patients with CHD were 0.753,0.506,0.856 and 0.915,respectively,the sensitivity were 83.1%,70.69%,83.1%and 85.77%,respectively,the specificity was 85.60%,62.87%,89.6%and 82.96%respectively.【Conclusion】The combined detection of TIMP-4,FFA and EAT thickness in serum is valuable in the diagnosis of cervical vascular disease in patients of T2DM with CHD,which can provide reference for early diagnosis,prevention and treatment of cervical vascular

关 键 词：糖尿病 2型/合并症 冠心病/合并症 金属蛋白酶4组织抑制剂 脂肪酸类 糖尿病血管病变 

分 类 号：R587.1[医药卫生—内分泌]