2型糖尿病患者血清γ-谷氨酰转移酶与颈动脉粥样硬化的关联性  

Association between serumγ-glutamyltransferase and carotid atherosclerosis in patients with type 2 diabetes mellitus

作　　者：李茂婷 何佩真 李睿[2] 周广举[1] LI Maoting;HE Peizhen;LI Rui;ZHOU Guangju(Department of Endocrinology,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China;Department of Imaging Medicine,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]川北医学院附属医院内分泌科,四川南充637000 [2]川北医学院附属医院影像医学科,四川南充637000

出　　处：《检验医学与临床》2024年第8期1025-1029,1034,共6页Laboratory Medicine and Clinic

基　　金：国家自然科学基金青年科学基金项目(81801674)。

摘　　要：目的采用观察性研究及孟德尔随机化(MR)分析探讨2型糖尿病(T2DM)患者血清γ-谷氨酰转移酶(GGT)与颈动脉粥样硬化(CAS)之间的关联性。方法选取2020年1月至2023年6月该院内分泌科收治的符合诊断标准的354例T2DM患者作为研究对象,将其中247例CAS患者作为CAS组,107例无CAS患者作为无CAS组,分析比较两组患者的基线特征。基于全基因组关联研究的汇总数据,采用两样本MR分析探讨GGT与CAS之间的因果关联。MR分析采用血清GGT水平相关的遗传位点作为工具变量,使用逆方差加权法(IVW)作为主要分析方法,辅以MR-Egger回归法和加权中位数法(WM),采用异质性检验、多效性检验和逐个剔除检验进一步进行敏感性分析。结果CAS组与无CAS组血清GGT水平比较,差异无统计学意义(P>0.05)。IVW结果不支持血清GGT水平与CAS之间存在因果效应(GGT→颈动脉内膜厚度:P=0.423;GGT→AS:P=0.345);MR-Egger回归法及WM的结果与IVW一致,也不支持血清GGT水平与CAS之间存在因果效应。多效性检验结果显示,该研究不存在水平多效性(GGT→颈动脉内膜厚度:MR-Egger回归截距=0.00,P=0.262;GGT→AS:MR-Egger回归截距=0.00,P=0.059)。结论观察性研究和MR分析结果均不支持血清GGT水平与CAS之间存在因果关联。Objective To investigate the association between serumγ-glutamyltransferase(GGT)and carotid atherosclerosis(CAS)in patients with type 2 diabetes mellitus(T2DM)using observational study and Mendelian randomization(MR)analysis.Methods A total of 354 patients with T2DM who met the diagnostic criteria and were admitted to the Department of Endocrinology of the hospital from January 2020 to June 2023 were selected as the research objects.Among them,247 patients with CAS were selected as the CAS group,and 107 patients without CAS were selected as the non-CAS group.Based on the pooled data from genome-wide association studies,two-sample MR was used to explore the causal association between GGT and CAS.The inverse variance weighting(IVW)method was used as the main analysis method,supplemented by MR-Egger regression and weighted median method.Heterogeneity test,pleiotropy test and exclusion test were used for further sensitivity analysis.Results There was no significant difference in serum GGT levels between the CAS group and the non-CAS group(P>0.05).IVW results did not support a causal effect between serum GGT level and CAS(GGT→carotid intima-media thickness:P=0.423,GGT→AS:P=0.345).The results of MR-Egger regression method and WM were consistent with IVW,and did not support a causal effect between serum GGT level and CAS.The results of pleiotropy test showed that there was no horizontal pleiotropy(GGT→carotid intima-media thickness:MR-Egger regression intercept=0.00,P=0.262,GGT→AS:MR-Egger regression intercept=0.00,P=0.059).Conclusion The results of both observational studies and MR Analysis do not support a causal association between serum GGT levels and CAS.

关 键 词：Γ-谷氨酰转移酶 2型糖尿病 颈动脉粥样硬化 观察性研究 孟德尔随机化 

分 类 号：R587.1[医药卫生—内分泌] R543.5[医药卫生—内科学]