机构地区:[1]新乡医学院第一附属医院内分泌科,河南卫辉453100
出 处:《海南医学》2024年第10期1390-1395,共6页Hainan Medical Journal
基 金:2019年度河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20190461)。
摘 要:目的探讨8-异前列腺素F2α(8-isoPGF2α)、镍纹样蛋白(Metrnl)、微管相关蛋白3B-Ⅱ(LC3B-Ⅱ)/微管相关蛋白-Ⅰ(LC3B-Ⅰ)与2型糖尿病(T2MD)患者血糖在目标范围内时间(TIR)的相关性及对糖尿病周围神经病变(DPN)预测价值。方法选取2020年5月至2022年10月新乡医学院第一附属医院收治的187例T2DM患者进行前瞻性研究,根据是否合并DPN分为DPN组(n=48)和无DPN组(n=139)。比较两组患者及根据TIR四分位数分组的患者8-isoPGF2α、Metrnl、LC3B-Ⅱ/LC3B-Ⅰ水平,采用Pearson相关性分析8-isoPGF2α、Metrnl、LC3B-Ⅱ/LC3B-Ⅰ与TIR相关性,采用多因素Logistic回归分析DPN的相关影响因素;绘制受试者工作特征曲线(ROC)评价8-isoPGF2α、Metrnl、LC3B-Ⅱ预测DPN的价值。结果DPN组患者的TIR为(51.43±7.68)%,明显低于无DPN组的(56.94±8.12)%,差异有统计学意义(P<0.05);DPN组患者的8-isoPGF2α、Metrnl分别为(162.78±51.33)pg/mL、(259.18±74.42)pg/mL,明显高于无DPN组的(129.56±43.00)pg/mL、(208.37±65.61)pg/mL,LC3B-Ⅱ/LC3B-Ⅰ为0.89±0.27,明显低于无DPN组的1.15±0.31,差异均有统计学意义(P<0.05);根据TIR第25、50、75百分位数将全部患者分为Q1~Q4四组,8-isoPGF2α、Metrnl在Q4组最低,LC3B-Ⅱ/LC3B-Ⅰ在Q4组最高;8-isoPGF2α、Metrnl随着TIR降低逐渐升高,LC3B-Ⅱ/LC3B-Ⅰ随着TIR降低而降低,四组间比较差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,8-isoPGF2α、Metrnl与TIR呈显著负相关(r=-0.786、-0.665,P<0.01),LC3B-Ⅱ/LC3B-Ⅰ与TIR呈显著正相关(r=0.711,P<0.01);多因素Logistic回归分析结果显示,TIR、LC3B-Ⅱ/LC3B-Ⅰ是DPN的独立相关保护因素(P<0.05),8-isoPGF2α、Metrnl是DPN的独立相关危险因素(P<0.05);ROC分析结果显示,单一指标中,Metrnl预测DPN的AUC最大(0.830),特异度最高(87.05%),8-isoPGF2α+Metrnl+LC3B-Ⅱ预测DPN的AUC为0.923(95%CI:0.875~0.957),大于Metrnl,预测敏感度为87.50%,特异度为85.61%(P<0.05)。结论8-isoPGF2α、Metrnl、LC3B-Ⅱ/LObjective To investigate the correlation between 8-isoprostaglandin F2α(8-isoPGF2α),nickel pat-tern protein(Metrnl),microtubule-associated protein 1 light chain 3B-Ⅱ(LC3B-Ⅱ)/microtubule-associated protein 1 light chain 3B-Ⅰ(LC3B-Ⅰ)and time in range in patients with type 2 diabetes mellitus(T2MD)and their predictive value on diabetic peripheral neuropathy(DPN).Methods A prospective study was conducted on 187 patients with T2DM admitted to the First Affiliated Hospital of Xinxiang Medical University from May 2020 to October 2022.The pa-tients were divided into DPN group(n=48)and non-DPN group(n=139)according to whether they had DPN.The levels of 8-isoPGF2α,Metrnl,LC3B-Ⅱ/LC3B-Ⅰwere compared between the two groups and among patients grouped ac-cording to TIR quartiles.Pearson correlation analysis was used to analyze the correlation between 8-isoPGF2α,Metrnl,LC3B-Ⅱ/LC3B-Ⅰand TIR,and multiple factor logistic regression analysis was used to analyze the related factors of DPN.The receiver operating characteristic curve(ROC)was used to evaluate the value of 8-isoPGF2α,Metrnl,LC3B-Ⅱin predicting DPN.Results The TIR of patients in the DPN group was(51.43±7.68)%,which was significantly lower than(56.94±8.12)%of patients in the non-DPN group(P<0.05).The levels of 8-isoPGF2αand Metrnl in the DPN group were(162.78±51.33)pg/mL and(259.18±74.42)pg/mL,respectively,which were significantly higher than(129.56±43.00)pg/mL and(208.37±65.61)pg/mL in the non-DPN group,respectively;the LC3B-Ⅱ/LC3B-Ⅰratio was 0.89±0.27,which was significantly lower than 1.15±0.31 in the non-DPN group;the differences were statistically signifi-cant(P<0.05).According to the 25th,50th,and 75th percentiles of TIR,the patients were divided into four groups:Q1 to Q4.The level of 8-isoPGF2αand Metrnl was the lowest in Q4,while the LC3B-Ⅱ/LC3B-Ⅰratio was the highest in Q4;the levels of 8-isoPGF2αand Metrnl gradually increased with the decrease of TIR,while the LC3B-Ⅱ/LC3B-Ⅰra-tio decreased with the decrease of TIR;the
关 键 词:8-异前列腺素F2Α 镍纹样蛋白 微管相关蛋白3B-Ⅱ/微管相关蛋白-Ⅰ 2型糖尿病 血糖在目标范围内时间 糖尿病周围神经病变 相关性 预测价值
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