2型糖尿病病人血清可溶性ST2与冠状动脉粥样硬化性心脏病的相关性研究  

Correlation between serum soluble ST2 and coronary atherosclerotic heart disease in patients with type 2 diabetes mellitus

作　　者：张玲仙 李敏[1] 李辉[2] 张然然 刘艳 杨青青[1,3] 孙卫华[1,3] 时照明[1,3] 胡小磊[1,3] ZHANG Ling-xian;LI Min;LI Hui;ZHANG Ran-ran;LIU Yan;YANG Qing-qing;SUN Wei-hua;SHI Zhao-ming;HU Xiao-lei(Department of Endocrinology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China;Department of Cardiovascular Medicine,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China;National Standardized Metabolic Disease Management Center,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院内分泌科,安徽蚌埠233004 [2]蚌埠医学院第一附属医院心血管内科,安徽蚌埠233004 [3]蚌埠医学院第一附属医院国家标准化代谢性疾病管理中心,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2023年第12期1640-1644,共5页Journal of Bengbu Medical College

基　　金：国家自然科学基金项目(81770803);安徽省高等学校自然科学研究重大项目(KJ2020ZD53);蚌埠医学院自然科学重大科技项目孵育计划(2020byfy004)。

摘　　要：目的:探讨2型糖尿病(T2DM)病人血清中可溶性ST2(sST2)与冠状动脉粥样硬化性心脏病(CAD)的关系。方法:选取334例接受冠状动脉造影(CAG)检查的病人,分成T2DM组77例,CAD组143例,T2DM+CAD组114例。另选取72名健康体检人群为对照组,收集各组的临床生化指标进行分析比较。依据Gensini评分将T2DM+CAD组分为轻度组31例和重度组83例。采用酶联免疫吸附法(ELISA)检测血清sST2水平,比较各组间的sST2水平差异并与Gensini评分进行相关性分析。结果:对照组、T2DM组、CAD组、T2DM+CAD组的各组间sST2差异有统计学意义(P<0.01);T2DM+CAD重度组sST2水平高于轻度组(P<0.05);多元线性逐步回归分析显示Gensini评分、HbA1c、LDL与血清sST2水平呈正相关(P<0.05~P<0.01),HDL与血清sST2水平呈负相关(P<0.05);二元logistic回归分析HbA1c、sST2、Gensini评分是T2DM合并CAD的危险因素(P<0.05~P<0.01),HDL是T2DM合并CAD的保护因素(P<0.01);sST2在评估T2DM合并CAD准确性的曲线下面积为0.851,敏感性为61.4%,特异性为92.1%。结论:血清sST2是T2DM合并CAD的危险因素;可作为评估T2DM合并CAD发生及严重程度的血清标志物。Objective To investigate the relationship between serum soluble ST2(sST2)and coronary atherosclerotic heart disease(CAD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 334 patients who underwent coronary angiography were selected and divided into three groups:77 cases in T2DM group,143 cases in CAD group,and 114 cases in T2DM combined with CAD group.Seventy-two healthy people were selected as the control group during the same period.The clinical biochemical indicators of each group were collected for analysis and comparison.According to the Gensini score,the T2DM combined with CAD group was divided into mild group with 31 cases and severe group with 83 cases.Serum sST2 levels were detected by ELISA,the differences of sST2 levels among the groups were compared and the correlation analysis was performed with Gensini score.Results There were statistically significant differences in sST2 among the control group,T2DM group,CAD group,and T2DM combined with CAD group(P<0.01).The sST2 level in the severe group was higher than that in the mild group of T2DM combined with CAD(P<0.05).Multivariate linear stepwise regression analysis showed that Gensini score,HbA1c,LDL were positively correlated with serum sST2 level(P<0.05 to P<0.01),while HDL was negatively correlated with serum sST2 level(P<0.05).Binary logistic regression analysis showed that HbA1c,sST2,and Gensini score were risk factors for T2DM combined with CAD(P<0.05 to P<0.01),and HDL was a protective factor for T2DM complicated with CAD(P<0.01).The area under the curve for the accuracy of T2DM combined with CAD was 0.851,the sensitivity was 61.4%,and the specificity was 92.1%.Conclusions Serum sST2 is a risk factor for T2DM combined with CAD,which can be used as a serum marker to evaluate the occurrence and severity.

关 键 词：2型糖尿病 可溶性ST2 冠状动脉粥样硬化性心脏病 GENSINI评分 

分 类 号：R587.1[医药卫生—内分泌]