老年2型糖尿病患者血清同型半胱氨酸、血清淀粉样蛋白A、S100β水平与颈动脉斑块稳定性的关系  

Relationship between serum homocysteine,serum amyloid A,and S100βlevels and carotid plaque stability in elderly patients with type 2 diabetes

作　　者：陈雅雯[1] 尹翰林[1] 王艳[1] Chen Yawen;Yin Hanlin;Wang Yan(Department of Geriatrics,People's Hospital of Deyang,Deyang 618000,China)

机构地区：[1]四川省德阳市人民医院老年医学科,618000

出　　处：《心脑血管病防治》2024年第9期26-29,45,共5页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨老年2型糖尿病患者血清同型半胱氨酸(Hcy)、血清淀粉样蛋白A(SAA)、S100β水平与颈动脉斑块稳定性的关系。方法选取2021年6月至2023年6月德阳市人民医院收治的186例老年2型糖尿病患者为病例组,同期体检的186例健康者为对照组,根据斑块情况将病例组患者分为不稳定斑块组57例,稳定斑块组32例,无斑块组97例。回顾性分析受试者血清Hcy、SAA、S100β水平及不稳定斑块组、稳定斑块组、无斑块组的临床资料。采用Spearman法分析老年2型糖尿病患者血清Hcy、SAA、S100β水平与颈动脉斑块稳定性的相关性,Logistic回归模型分析老年2型糖尿病患者颈动脉斑块稳定性的影响因素,ROC曲线分析Hcy、SAA、S100β评估老年2型糖尿病患者颈动脉不稳定斑块的效能。结果病例组患者血清Hcy、SAA、S100β水平高于对照组(t=28.737、40.946、57.982,P<0.05);不稳定斑块组、稳定斑块组、无斑块组三组间糖尿病病程、空腹血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白、Hcy、SAA、S100β差异有统计学意义(P<0.05);老年2型糖尿病患者血清Hcy、SAA、S100β水平均与颈动脉斑块的不稳定性呈正相关(r=0.802、0.669、0.745,P<0.01);糖尿病病程、糖化血红蛋白、低密度脂蛋白、Hcy、SAA、S100β是老年2型糖尿病患者颈动脉不稳定斑块的危险因素(OR=1.384、1.582、2.147、2.560、2.309、3.728,P<0.05);Hcy、SAA、S100β均可评估老年2型糖尿病患者颈动脉不稳定斑块,三项联合评估的效能优于单项评估(Z=2.217、1.995、1.986,P<0.05)。结论老年2型糖尿病患者血清Hcy、SAA、S100β水平与颈动脉斑块稳定性相关,三项联合评估颈动脉不稳定斑块的效能优于单项评估。Objective To explore the relationship between serum homocysteine(Hcy),serum amyloid A(SAA),and S100βlevels and carotid plaque stability in elderly patients with type 2 diabetes.Methods A total of 186 elderly patients with type 2 diabetes admitted to People's Hospital of Deyang from June 2021 to June 2023 were selected as the case group,and 186 healthy individuals undergoing physical examinations during the same period served as the control group.Based on plaque status,patients in the case group were divided into an unstable plaque group(57 cases),a stable plaque group(32 cases),and a no-plaque group(97 cases).The serum Hcy,SAA,and S100βlevels were retrospectively analyzed,along with clinical data from the unstable plaque group,stable plaque group,and no-plaque group.The correlation between serum Hcy,SAA,and S100βlevels and carotid plaque stability in elderly patients with type 2 diabetes was analyzed using Spearman correlation analysis,and the influencing factors of carotid plaque stability in elderly patients with type 2 diabetes were analyzed using Logistic regression model.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum Hcy,SAA,and S100βlevels in evaluating unstable carotid plaques in elderly patients with type 2 diabetes.Results The serum levels of Hcy,SAA and S100βin the case group were higher than those in the control group(t=28.737,40.946,57.982;P<0.05).There were significant differences in the duration of diabetes,fasting blood glucose,glycated hemoglobin,total cholesterol,low-density lipoprotein,Hcy,SAA,and S100βlevels among the unstable plaque group,stable plaque group,and no-plaque group(P<0.05).The serum levels of Hcy,SAA,and S100βin elderly patients with type 2 diabetes were positively correlated with the stability of carotid plaques(r=0.802,0.669,0.745;P<0.01).The duration of diabetes,glycated hemoglobin,low-density lipoprotein,Hcy,SAA,and S100βwere identified as risk factors for unstable carotid plaques in elderly patients with type 2 diabetes(OR=1.

关 键 词：老年人 2型糖尿病 同型半胱氨酸 血清淀粉样蛋白A S100Β 颈动脉斑块 

分 类 号：R587.1[医药卫生—内分泌]