血清游离脂肪酸和心型脂肪酸结合蛋白表达与2型糖尿病病人动脉粥样硬化斑块的关系研究  

Study on the relationship between the expression of serum free fatty acid and heart type fatty acid binding protein and atherosclerotic plaque in type 2 diabetes patients

作　　者：张明华 安亚琴 孙丽静 张静歌 张玲玲 王丽 游向东 ZHANG Minghua;AN Yaqin;SUN Lijing;ZHANG Jingge;ZHANG Lingling;WANG Li;YOU Xiangdong(Department of Endocrinology,Baoding Fourth Central Hospital,Baoding,Hebei 072350,China;Department of Cardiology,Baoding Fourth Central Hospital,Baoding,Hebei 072350,China)

机构地区：[1]保定市第四中心医院内分泌科,河北保定072350 [2]保定市第四中心医院心内科,河北保定072350

出　　处：《安徽医药》2025年第1期151-155,共5页Anhui Medical and Pharmaceutical Journal

基　　金：保定市科技局课题项目(2241ZF022)。

摘　　要：目的探讨血清游离脂肪酸(FFA)和心型脂肪酸结合蛋白(H-FABP)表达与2型糖尿病(T2DM)病人动脉粥样硬化斑块(CAP)的关系研究。方法选取2020年6月至2022年6月保定市第四中心医院接收的T2DM病人302例为研究对象。通过颈动脉超声检查进一步将研究对象分为CAP组(165例)和无CAP组(137例)。采用酶联免疫吸附测定(ELISA)检测血清FFA、H-FABP水平;采用logistic多因素回归分析CAP发生的影响因素;采用Spearman法分析血清FFA、H-FABP水平及与临床资料的相关性分析;采用受试者操作特征曲线(ROC曲线)评价血清FFA、H-FABP及其联合对CAP发生的诊断效能。结果相较于无CAP组,CAP组年龄、高血压史、C反应蛋白(CRP)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL)、载脂蛋白A(ApoA)、FFA、H-FABP[(4.63±1.43)μg/L比(3.68±1.05)μg/L]水平显著上升(P<0.05),LPa水平显著下降(P<0.05)。logistic分析显示,年龄、CRP、TG、LDL、FFA、H-FABP均是T2DM病人CAP发生的独立危险因素(P<0.05)。T2DM合并CAP病人血清FFA与H-FABP、年龄、CRP、TG、LDL水平呈正相关(rs=0.61、0.59、0.52、0.57、0.55,P<0.05)。血清H-FABP与年龄、CRP、TG、LDL水平呈正相关(rs=0.58、0.53、0.57、0.54,P<0.05)。ROC曲线结果显示血清中FFA、H-FABP水平及二者联合预测T2DM病人CAP发生的AUC分别为0.71、0.74、0.84,其中联合预测AUC显著高于二者单独预测AUC(Z=3.65、2.68,P<0.05)。结论FFA、H-FABP水平在T2DM合并CAP病人血清中升高,与年龄、CRP、TG、LDL关系密切,均有望成为T2DM病人CAP发生的诊断因子。Objective To investigate the relationship between the expression of serum free fatty acid(FFA)and heart type fatty acid binding protein(H-FABP)and atherosclerotic plaque(CAP)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 302 patients with T2DM admitted to the fourth Central Hospital of Baoding from June 2020 to June 2022 were selected as the research objects.The subjects were further grouped into CAP group(165 cases)and non-CAP group(137 cases)by carotid ultrasound examination.The levels of serum FFA and H-FABP were detected by enzyme-linked immunosorbent assay(ELISA);Logistic multiple factor regression was applied to analyze the influencing factors of CAP;the levels of serum FFA,H-FABP and their correlation with clinical data were analyzed by Spearman method;Receiver operating characteristic curve(ROC curve)was used to evaluate the diagnostic efficacy of serum FFA,H-FABP and their combination for CAP.Results Compared with non-CAP group,the age,history of hypertension,C-reactive protein(CRP),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL),apolipoprotein A(ApoA),FFA,H-FABP[(4.63±1.43)μg/Lvs.(3.68±1.05)μg/L]levels in CAP group increased obviously(P<0.05),the level of LPA decreased obviously(P<0.05).Logistic analysis showed that age,CRP,TG,LDL,FFA and H-FABP were independent risk factors for CAP in T2DM patients(P<0.05).The serum FFA of T2DM patients with CAP was positively correlated with the levels of H-FABP,age,CRP,TG and LDL(rs=0.61,0.59,0.52,0.57,0.55,P<0.05).Serum H-FABP was positively correlated with age,CRP,TG and LDL levels(rs=0.58,0.53,0.57,0.54,P<0.05).The ROC curve results showed that the AUC of FFA,H-FABP levels in serum and their combination in predicting CAP in T2DM patients were 0.71,0.74 and 0.84,respectively,and the AUC of combined prediction was obviously higher than that of the two alone(Z=3.65,2.68,P<0.05).Conclusion The levels of FFA and H-FABP increase in the serum of T2DM patients with CAP,which are closely related to age,CRP,TG and LDL,and are expected to

关 键 词：糖尿病 2型 斑块 动脉粥样硬化 游离脂肪酸 心型脂肪酸结合蛋白 相关性 诊断 

分 类 号：R587.1[医药卫生—内分泌] R543.5[医药卫生—内科学]