血清RBP4和α2-MG与2型糖尿病微血管并发症及治疗后临床结局的关系研究  

Relationship between serum RBP4 andα2-MG and microvascular complications of type 2 diabetes mellitus and clinical outcome after treatment

作　　者：崔晓磊[1] 王俊宏[1] 刘艳晓[1] 禹远远[1] 李进[1] CUI Xiao-lei;WANG Jun-hong;LIU Yan-xiao;YU Yuan-yuan;LI Jin(Department of Endocrinology,the First People's Hospital of Pingdingshan,Pingdingshan,Henan 467000,China)

机构地区：[1]平顶山市第一人民医院内分泌代谢科,河南平顶山467000

出　　处：《医药论坛杂志》2024年第13期1394-1398,共5页Journal of Medical Forum

摘　　要：目的分析血清视黄醇结合蛋白4(retinol binding protein 4,RBP4)和α2-微球蛋白(α2-macroglobulin,α2-MG)与2型糖尿病微血管并发症(type 2 diabetes microvascular complications,DMA)及治疗后临床结局的关系。方法选取2015年6月至2018年6月平顶山市第一人民医院收治的T2DM患者180例,根据是否存在DMA分为无DMA组(97例)、DMA组(83例)。比较无DMA组、DMA组血清RBP4、α2-MG水平;用logistic回归模型分析T2DM患者发生DMA的影响因素;随访5年统计DMA治疗后临床结局,将发生不良结局的患者纳入不良组(35例),其余患者纳入良好组(39例);比较良好组、不良组血清RBP4、α2-MG水平;建立受试者工作曲线(ROC)评估血清RBP4、α2-MG对DMA治疗后临床结局的预测价值。结果与无DMA组比较,DMA组年龄、吸烟史百分率、HbA1c、空腹血糖、RBP4及α2-MG水平升高,T2DM病程延长(P<0.05)。logistic回归模型显示,年龄、吸烟史、T2DM病程、空腹血糖、RBP4、α2-MG是T2DM患者发生DMA的影响因素(P<0.05)。与良好组比较,不良组血清RBP4、α2-MG水平升高(P<0.05)。ROC曲线显示,血清RBP4、α2-MG预测DMA治疗后临床结局不良的最佳截断点分别为80.68 mg/L、1.37 mg/mL,两者单独及联合检测的AUC分别为0.777、0.700、0.862。结论血清RBP4、α2-MG水平高是DMA发生的危险因素,且两者联合检测对DMA治疗后临床结局具有较高的预测价值。Objective To analyze the relationship between serum retinol binding protein 4(RBP4),α2-macroglobulin(α2-MG)and type 2 diabetes microvascular complications(DMA)and clinical outcomes after treatment.Methods A total of 180 patients with T2DM admitted to the First People's Hospital of Pingdingshan from June 2015 to June 2018 were selected,and divided into non-DMA group(97 cases)and DMA group(83 cases)according to whether they had DMA.The serum RBP4 andα2-MG levels of the non-DMA group and the DMA group were compared.Logistic regression model was used to analyze the influencing factors of DMA occurrence in T2DM patients.The clinical outcomes after DMA treatment were followed up for 5 years,and the patients who had adverse outcomes were included in the adverse group(35 cases),and the rest of the patients were included in the good group(39 cases).The serum RBP4 andα2-MG levels of the good group and the adverse group were compared.Receiver operating characteristic curve(ROC)was established to evaluate the predictive value of serum RBP4 andα2-MG for clinical outcomes after DMA treatment.Results Compared with the non-DMA group,the age,smoking history percentage,HbA1c,fasting blood glucose,RBP4 andα2-MG levels of the DMA group were increased,and the T2DM course was prolonged(P<0.05).Logistic regression model showed that age,smoking history,T2DM course,fasting blood glucose,RBP4,α2-MG were influencing factors for DMA occurrence in T2DM patients(P<0.05).Compared with the good group,the serum RBP4 andα2-MG levels of the adverse group increased(P<0.05).ROC curve showed that the best cut-off points for serum RBP4 andα2-MG to predict adverse clinical outcomes after DMA treatment were 80.68 mg/L and 1.37 mg/mL respectively,and the AUCs of single and combined detection of both were 0.777,0.700,0.862 respectively.Conclusion High serum RBP4 andα2-MG levels are risk factors for DMA occurrence,and combined detection of both has a high predictive value for clinical outcomes after DMA treatment.

关 键 词：2型糖尿病 微血管并发症 视黄醇结合蛋白4 α2-微球蛋白 临床结局 

分 类 号：R587.2[医药卫生—内分泌]