血清Hcy、sdLDL-C水平与2型糖尿病下肢动脉血管病变的相关性  

Correlation between serum Hcy,sdLDL-C levels and lower extremity arterial disease in type 2 diabetes mellitus

作　　者：蒋凯丰 万寒梅 JIANG Kai-feng;WAN Han-mei(Department of Laboratory,the Central Hospital of Yongzhou,Yongzhou 425000,Hunan,China;Department of Precision Medicine,the Central Hospital of Yongzhou,Yongzhou 425000,Hunan,China)

机构地区：[1]永州市中心医院检验科,湖南永州425000 [2]永州市中心医院精准医学科,湖南永州425000

出　　处：《川北医学院学报》2024年第6期839-842,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨血清同型半胱氨酸(Hcy)、小而密低密度脂蛋白胆固醇(sdLDL-C)水平与2型糖尿病(T2DM)下肢动脉血管病变(LEAD)的相关性。方法:选取120例T2DM患者为研究对象,根据踝肱指数(ABI)分为单纯T2DM组(ABI>0.90,n=55)和LEAD组(ABI≤0.90,n=65);另选同期60名健康体检者为对照组。比较各组血糖[空腹血糖(FPG)、糖化血红蛋白(HbA1c)]、血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、Hcy和sdLDL-C水平;Pearson相关系数分析血清Hcy、sdLDL-C与LEAD的相关性;Logistic回归模型筛选LEAD的危险因素;受试者工作特征(ROC)曲线分析血清Hcy和sdLDL-C对LEAD的预测价值。结果:与对照组相比,T2DM组和LEAD组血清FPG、TC、TG、LDL-C、HbA1c、Hcy和sdLDL-C水平均更高(P<0.05),HDL-C水平均更低(P<0.05);与T2DM组相比,LEAD组血清FPG、TC、TG、Hcy和sdLDL-C水平均更高(P<0.05),但两组HDL-C、LDL-C和HbA1c水平差异均无统计学意义(P>0.05)。相关性分析显示,血清Hcy和sdLDL-C水平与ABI负相关(P<0.001)。回归分析显示,Hcy和sdLDL-C的OR值分别为1.531、1.662,是T2DM患者发生LEAD的独立危险因素(P<0.05)。ROC曲线分析显示,Hcy、sdLDL-C及二者联合预测LEAD的曲线下面积(AUC)分别为0.849、0.857、0.935,二者联合预测的价值最高。结论:血清Hcy和sdLDL-C水平升高与T2DM患者发生LEAD有关,联合应用对LEAD的预测价值较高。Objective:To investigate the correlation between serum homocysteine(Hcy),small and dense low density lipoprotein cholesterol(sdLDL-C)levels and lower extremity arterial disease(LEAD)in type 2 diabetes mellitus(T2DM).Methods:The clinical data of 120 patients with T2DM retrospectively analyzed.According to the ankle brachial index(ABI),they were divided into simple T2DM group(ABI>0.90,n=55)and LEAD group(ABI≤0.90,n=65).At the same time,60 healthy subjects were selected as the control group.The levels of blood glucose[fasting blood glucose(FPG),glycated hemoglobin(HbA1c)],blood lipid[total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],homocysteine(Hcy)and small and dense low density lipoprotein cholesterol(sdLDL-C)were compared among the three groups.Pearson correlation coefficient was used to analyze the correlation between serum Hcy,sdLDL-C and LEAD.Logistic regression model was used to analyze the risk factors of LEAD in patients with T2 DM.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum Hcy and sdLDL-C for LEAD.Results:The levels of serum FPG,TC,TG,LDL-C,HbA1 c,Hcy and sdLDL-C in T2DM group and LEAD group were higher than those in control group(P<0.05),and the level of HDL-C was lower than that in control group(P<0.05).The levels of serum FPG,TC,TG,Hcy and sdLDL-C in LEAD group were higher than those in T2DM group(P<0.05),but there was no significant difference in the levels of HDL-C,LDL-C and HbA1 c between LEAD group and T2DM group(P>0.05).Correlation analysis showed that serum Hcy and sdLDL-C levels were negatively correlated with ABI(P<0.001).Multivariate Logistic regression analysis showed that the OR values of Hcy and sdLDL-C were 1.531 and 1.662,respectively,which were independent risk factors for LEAD in T2DM patients(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of Hcy,sdLDL-C and their combined prediction of LEAD was 0.849,0.857 and 0.935,respectively,and

关 键 词：2型糖尿病 下肢动脉血管病变 同型半胱氨酸 小而密低密度脂蛋白胆固醇 

分 类 号：R587.1[医药卫生—内分泌]