ApoB、ApoA1及二者比值与2型糖尿病患者微血管并发症的关系  

Relationship between ApoB,ApoA1 and their ratio and microvascular complications in pa⁃tients with type 2 diabetes

作　　者：吴玲 李静静 龚源 奚超 李航 范文杰 WU Ling;LI Jingjing;GONG Yuan;XI Chao;LI Hang;FAN Wenjie(Department of Endocrinology,Xuancheng Central Hospital,Xuancheng,Anhui,China,242000)

机构地区：[1]宣城市中心医院内分泌科,安徽宣城242000

出　　处：《分子诊断与治疗杂志》2024年第12期2311-2314,2319,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省重点研究与开发计划项目(201904a07020053)。

摘　　要：目的探讨载脂蛋白B(ApoB)、载脂蛋白A1(ApoA1)及二者比值与2型糖尿病(T2DM)患者微血管并发症的关系。方法将2021年1月至2023年12月宣城市中心医院收治的110例T2DM患者作为本次研究对象,根据是否发生微血管并发症分为并发症组47例、单纯T2DM组63例。另外选取同时期在本院进行体检的150名健康人作为对照组。比较三组血清ApoB、ApoA1水平及ApoB/ApoA1比值;采用受试者工作特性(ROC)曲线评估ApoB、ApoA1、ApoB/ApoA1比值对T2DM患者微血管并发症的预测价值;采用二分类Logistic逐步回归分析探讨T2DM患者微血管并发症的影响因素。结果血清ApoB水平及ApoB/ApoA1比值:对照组<单纯T2DM组<并发症组,血清ApoA1水平:对照组>单纯T2DM组>并发症组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,ApoB、ApoA1、ApoB/ApoA1比值预测T2DM患者微血管并发症的曲线下面积(AUC)95%CI分别为0.744(0.692~0.796)、0.862(0.810~0.914)、0.901(0.849~0.953)。并发症组合并高血压占比、T2DM病程≥10年占比、空腹血糖、HbAlc、HOMA⁃IR、总胆固醇、血肌酐大于单纯T2DM组,差异有统计学意义(P<0.05)。多因素回归分析显示,T2DM病程长、HOMA⁃IR水平高、HbAlc水平高、ApoB/ApoA1比值升高是T2DM患者微血管并发症的独立危险因素(P<0.05)。结论ApoB/ApoA1比值预测T2DM患者微血管并发症的效能比血清ApoB、ApoA1单个指标预测好,监测ApoB/ApoA1比值变化可为临床治疗提供指导。Objective To investigate the relationship between apolipoprotein B(ApoB),Apoli⁃poprotein A1(ApoA1)and their ratio and microvascular complications in patients with type 2 diabetes melli⁃tus(T2DM).Methods 110 T2DM patients admitted to our hospital from January 2021 to December 2023 were selected as the subjects of this study.They were divided into two groups:the complication group(47 cases)and the simple T2DM group(63 cases)based on whether microvascular complications occurred.In ad⁃dition,150 healthy individuals who underwent physical examinations in our hospital during the same period were chosen as the control group.Serum levels of ApoB and ApoA1 and the ApoB/ApoA1 ratio were com⁃pared among the three groups.The predictive value of ApoB,ApoA1 and the ApoB/ApoA1 ratio for microvas⁃cular complications in T2DM patients was evaluated using ROC analysis.Factors influencing microvascular complications in T2DM patients were assessed through binary logistic stepwise regression.Results Serum ApoB levels and the ApoB/ApoA1 ratio were found to be orders of:control group<simple T2DM group<com⁃plication group,while serum ApoA1 level:control group>simple T2DM group>complication group(P<0.05).The area under the curve(AUC)95%confidence interval(CI)of ApoB,ApoA1 and the ApoB/ApoA1 ratio for predicting microvascular complications in T2DM patients were 0.744(0.692~0.796),0.862(0.810~0.914)and 0.901(0.849~0.953).The proportion of complications combined with hypertension,the proportion of T2DM duration≥10 years,fasting blood glucose,HbAlc,HOMA⁃IR,total cholesterol and se⁃rum creatinine were higher than those of the T2DM group alone(P<0.05).A long course of T2DM disease,high level of HOMA⁃IR and high level of HbAlc and elevated ApoB/ApoA1 ratio were independent risk factors for microvascular complications in T2DM patients(P<0.05).Conclusion The ApoB/ApoA1 ratio is more effective in predicting microvascular complications in T2DM patients than using serum ApoB and ApoA1 as individual factor.Monitoring changes of the

关 键 词：2型糖尿病 微血管并发症 ApoB/ApoA1比值 载脂蛋白B 

分 类 号：R587.2[医药卫生—内分泌]