2型糖尿病合并脑梗死患者血清FGF21、RAGE、DKK1表达情况及其意义  

Expression and significance of serum FGF21,RAGE and DKK1 in patients with type 2 diabetes mellitus complicated with cerebral infarction

作　　者：董靖 张佳佳 刘敏 向林 DONG Jing;ZHANG Jia-jia;LIU Min(Department of Endocrinology,General Hospital of Central Theater Command,Wuhan Hubei 430070,China)

机构地区：[1]中部战区总医院内分泌科,湖北武汉430070

出　　处：《临床和实验医学杂志》2024年第12期1237-1241,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金青年基金项目(编号:82000776)。

摘　　要：目的探讨2型糖尿病(T2DM)合并脑梗死患者血清成纤维细胞生长因子(FGF)21、晚期糖基化终末产物受体(RAGE)及Dickkopf-1蛋白(DKK1)表达情况及其意义。方法前瞻性选取2021年6月至2023年6月于中部战区总医院治疗T2DM合并脑梗死患者300例纳入试验组,选择同期于本院接受治疗的T2DM患者300例纳入T2DM组,选择同期于本院进行体检的健康者300名纳入对照组。检测并比较3组血清FGF21、RAGE、DKK1表达水平;分析血清FGF21、RAGE、DKK1对T2DM合并脑梗死的诊断价值;分析不同预后T2DM合并脑梗死患者临床资料和血清FGF21、RAGE、DKK1表达水平;分析血清FGF21、RAGE、DKK1与T2DM合并脑梗死预后的相关性;采用多因素Logistic回归分析分析血清FGF21、RAGE、DKK1对T2DM合并脑梗死预后的预测价值。结果试验组血清FGF21、RAGE、DKK1表达水平分别为(3.45±0.36)ng/L、(789.74±80.57)μg/mL、(98.76±9.92)ng/mL,均大于T2DM组[(2.68±0.29)ng/L、(578.06±59.84)μg/mL、(44.76±4.65)ng/mL]及对照组[(1.52±0.17)ng/L、(289.75±30.38)μg/mL、(24.95±2.64)ng/mL],差异均有统计学意义(P<0.05)。经受试者工作特征(ROC)曲线分析,血清FGF21、RAGE及DKK1联合诊断T2DM合并脑梗死的临床价值高于血清FGF21、RAGE及DKK1单一诊断的临床价值。预后不良患者和预后良好患者的性别构成比、年龄、体重指数、随机血糖比较,差异均无统计学意义(P>0.05);预后不良患者的糖化血红蛋白(HbA1c)、FGF21、RAGE、DKK1分别为(8.42±0.86)%、(3.89±0.40)ng/L、(865.64±89.43)μg/mL、(125.64±14.26)ng/mL,均大于预后良好患者[(7.04±0.73)%、(3.11±0.33)ng/L、(735.08±75.07)μg/mL、(83.64±8.61)ng/mL],差异均有统计学意义(P<0.05)。经Spearman相关分析,血清FGF21、RAGE、DKK1与T2DM合并脑梗死预后均呈负相关(r=-0.624、-0.553、-0.726,P<0.05)。经Logistic回归分析,结果显示HbA1c、FGF21、RAGE、DKK1均为影响T2DM合并脑梗死预后的独立危险因素(P<0.05)。结�Objective To investigate the expression and significance of serum fibroblast growth factor 21(FGF21),receptors for advanced glycation end products(RAGE)and Dickkopf-1 protein(DKK1)in patients with type 2 diabetes mellitus(T2DM)complicated with cerebral infarction.Methods A total of 300 T2DM complicated with cerebral infarction treated in General Hospital of Central Theater Command from June 2021 to June 2023 were prospectively selected to be included in the experimental group,300 T2DM patients treated in our hospital during the same period were included in the T2DM group,and 300 healthy subjects who underwent physical examination in our hospital during the same period were selected to be included in the control group.The expression of serum FGF21,RAGE and DKK1 were detected and compared among the three groups.The diagnostic value of serum FGF21,RAGE and DKK1 in T2DM complicated with cerebral infarction was analyzed.The clinical data and expression levels of serum FGF21,RAGE and DKK1 in T2DM complicated with cerebral infarction patients with different prognosis were analyzed.The correlation between serum FGF21,RAGE,DKK1 and prognosis of T2DM complicated with cerebral infarction was analyzed.The predictive value of serum FGF21,RAGE and DKK1 in T2DM complicated with cerebral infarction was analyzed by multivoriate Logistic regression analysis.Results The expression levels of FGF21,RAGE and DKK1 in the experimental group were(3.45±0.36)ng/L,(789.74±80.57)μg/mL and(98.76±9.92)ng/mL,respectively,which were higher than those in the T2DM group[(2.68±0.29)ng/L,(578.06±59.84)μg/mL,(44.76±4.65)ng/mL]and in the control group[(1.52±0.17)ng/L,(289.75±30.38)μg/mL,(24.95±2.64)ng/mL],the differences were statistically significant(P<0.05).According to receiver operating characteristic(ROC)curve analysis,the clinical value of serum FGF21,RAGE and DKK1 in the combined diagnosis of T2DM complicated with cerebral infarction was higher than that of serum FGF21,RAGE and DKK1 alone.There were no statistically significant diff

关 键 词：2型糖尿病 脑梗死 成纤维细胞生长因子21 晚期糖基化终产物受体 Dickkopf-1蛋白 

分 类 号：R587.1[医药卫生—内分泌] R743.33[医药卫生—内科学]