2型糖尿病患者血清肌生成抑制素与动脉粥样硬化性心血管疾病相关性的研究  

The correlation analysis between serum MSTN and atherosclerotic cardiovascular disease in patients with type 2 diabetes mellitus

作　　者：董俐 罗晓红 王春雨 马凌 贾春晖 许瑞元 万东君 DONG Li;LUO Xiaohong;WANG Chunyu(Department of Endocrinology,The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army,Lanzhou 730050,China)

机构地区：[1]中国人民解放军联勤保障部队第九四〇医院内分泌科,兰州730050 [2]中国人民解放军联勤保障部队第九四〇医院心内科,兰州730050 [3]中国人民解放军联勤保障部队第九四〇医院神经内科,兰州730050

出　　处：《中国糖尿病杂志》2024年第4期275-280,共6页Chinese Journal of Diabetes

基　　金：中国人民解放军联勤保障部队第九四〇医院院内课题“面上项目”(2021yxky040)。

摘　　要：目的探讨T2DM患者血清肌生成抑制素(MSTN)与动脉粥样硬化性心血管疾病(ASCVD)的相关性。方法选取2021年1~7月于中国人民解放军联勤保障部队第九四〇医院内分泌科、心内科、神经内科住院治疗患者139例,根据患病情况分为单纯T2DM组(n=31)、单纯ASCVD组(n=34)、T2DM合并无急性ASCVD组(T2DM+no-acute ASCVD,n=39)、T2DM合并急性ASCVD组(T2DM+acute ASCVD,n=35)。另选取同期我院体检健康者20名为正常对照(NC)组。收集各组生化指标,采用ELISA法检测血清MSTN。Spearman相关分析血清MSTN与其它生化指标的相关性,多元线性逐步回归分析血清MSTN的影响因素,Logistic回归分析T2DM合并ASCVD的影响因素,受试者工作特征(ROC)曲线分析血清MSTN对T2DM合并ASCVD的诊断价值。结果T2DM、ASCVD、T2DM+no-acute ASCVD、T2DM+acute ASCVD组血清MSTN高于NC组(P<0.05),T2DM+acuteASCVD组血清MSTN高于T2DM组(P<0.05),T2DM+no-acute ASCVD、T2DM+acute ASCVD组血清MSTN高于ASCVD组(P<0.05)。Spearman相关分析显示,血清MSTN与年龄、DM病程、FPG、HbA1c、糖化血清蛋白、BUN呈正相关(P<0.05)。多元线性逐步回归分析显示,性别、年龄、HbA1c、血肌酐(Scr)是血清MSTN的影响因素。Logistic回归分析显示,性别、年龄、DM病程、红细胞沉降率和MSTN是T2DM合并ASCVD的影响因素。ROC曲线分析显示,血清MSTN检测的ROC曲线下面积为0.841,敏感度为70.27%,特异度为85.53%,截断值为1.28 pg/ml,诊断符合率为77.36%。结论血清MSTN升高与T2DM合并ASCVD相关,可能是早期筛查T2DM合并ASCVD新的血清生物学标志物。Objective To investigate the correlation between serum myostatin(MSTN)and atherosclerotic cardiovascular disease(ASCVD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 139 in patients were selected from 94Oth Hospital of The PLA Joint Service Support Force from January to July 2021.The patients were divided into T2DM group(n=31),ASCVD group(n=34),T2DM+no acute ASCVD group((n=39)and T2DM+acute ASCVD group(n=35).In addition,20 healthy people in the same period were selected as the normal control(NC)group.Biochemical indicators were collected and serum MSTN was detected by ELISA.Multivariate linear regression was used to analyze the influencing factors of serum MSTN.Logistic regression was used to analyze the influencing factors of T2DM with ASCVD.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum MSTN for T2DM with ASCVD.Results Serum MSTN was significantly higher in T2DM,ASCVD,T2DM+no-acute ASCVD and T2DM+acute ASCVD groups than in NC group(P<0.05).The T2DM+acute ASCVD group had a significantly higher serum MSTN level than T2DM group(P<0.05).The serum MSTN level was significantly higher in T2DM+no-acute ASCVD and T2DM+acute ASCVD groups than ASCVD group(P<0.05).Spearman correlation analysis showed that serum MSTN was positively correlated with age,DM duration,FPG,HbAic,GSP and BUN(P<0.05).Multiple linear stepwise regression analysis showed that gender,age,HbAic and Scr were the influencing factors of serum MSTN.Logistic regression analysis showed that gender,age,duration of DM,ESR and MSTN were the influencing factors of T2DM complicated with ASCVD.ROC curve analysis showed that the area under the curve of serum MSTN was 0.841 with the sensitivity 70.27%and the specificity 85.53%,the cut-off value was 1.28 pg/ml,and the diagnostic coincidence rate was 77.36%.Conclusion Elevated serum MSTN is associated with ASCVD in T2DM patients,which may be a new serum biomarker for early screening of T2DM with A.SCVD.

关 键 词：糖尿病 2型 肌生成抑制素 动脉粥样硬化性心血管疾病 

分 类 号：R58[医药卫生—内分泌]