血清sP-selectin、sE-selectin对原发性高血压伴2型糖尿病的诊断价值及其与胰岛素抵抗的关系  

Diagnostic value of serum sP-selectin and sE-selectin for essential hypertension with type 2 diabetes and their correlation with insulin resistance

作　　者：谷君[1] 张志英[1] 宁改君[1] 邓文娟[1] 胡利梅[1] 刘慧颖[1] 蔡裕 任卫东[1] GU Jun;ZHANG Zhiying;NING Gaijun;DENG Wenjuan;HU Limei;LIU Huiying;CAI Yu;REN Weidong(Department of Endocrinology,the First Affiliated Hospital of Hebei North University,Shijiazhuang,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院内分泌科,河北石家庄075000

出　　处：《检验医学与临床》2025年第6期805-809,共5页Laboratory Medicine and Clinic

基　　金：河北省卫生健康委员会医学科学研究课题计划项目(20190875);河北省张家口市科技计划财政资助项目(1911021D-7)。

摘　　要：目的探讨血清可溶性P-选择素(sP-selectin)、可溶性E-选择素(sE-selectin)对原发性高血压(EH)伴2型糖尿病(T2DM)的诊断价值及其与胰岛素抵抗的关系。方法选取2019年9月至2021年9月该院收治的124例EH患者作为研究对象,根据是否伴有T2DM将其分为非T2DM组66例和T2DM组58例;另选取同期在该院体检的50例健康志愿者作为对照组。收集研究对象的收缩压、舒张压、脉压及甘油三酯、胆固醇、空腹血糖水平等临床资料;采用酶联免疫吸附试验检测血清sP-selectin、sE-selectin水平;采用电化学发光法测定空腹胰岛素水平,并计算胰岛素抵抗指数。采用Pearson相关分析T2DM患者血清sP-selectin、sE-selectin水平与空腹胰岛素水平、胰岛素抵抗指数的相关性;绘制受试者工作特征(ROC)曲线分析血清sP-selectin、sE-selectin对EH伴T2DM的诊断价值。结果与对照组比较,非T2DM组、T2DM组收缩压、舒张压、脉压及甘油三酯、胆固醇、空腹血糖水平均明显升高(P<0.05);与非T2DM组比较,T2DM组甘油三酯、胆固醇、空腹血糖水平均明显升高(P<0.05)。血清sP-selectin、sE-selectin水平及空腹胰岛素水平、胰岛素抵抗指数在对照组<非T2DM组<T2DM组,且两两比较,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,T2DM患者血清sP-selectin、sE-selectin水平与空腹胰岛素水平、胰岛素抵抗指数均呈正相关(P<0.05)。ROC曲线分析结果显示,血清sP-selectin、sE-selectin联合诊断EH伴T2DM的曲线下面积优于各指标单独诊断(Z二者联合-sP-selectin=2.099、P=0.036;Z二者联合-sE-selectin=2.998、P=0.003)。结论EH伴T2DM患者血清sP-selectin、sE-selectin水平升高,且与空腹胰岛素水平、胰岛素抵抗指数呈正相关,二者联合检测对EH伴T2DM具有较高的诊断价值。Objective To explore the diagnostic value of serum soluble P-selectin(sP-selectin)and soluble E-selectin(sE-selectin)in essential hypertension(EH)with type 2 diabetes(T2DM)and their relationship with insulin resistance.Methods A total of 124 EH patients admitted to the hospital from September 2019 to September 2021 were selected as the research subjects,which were divided into non-T2DM group with 66 cases and T2DM group with 58 cases based on whether they were accompanied by T2DM or not,meanwhile 50 healthy volunteers who had medical checkups in the hospital during the same period were selected as the control group.Clinical data including systolic blood pressure,diastolic blood pressure,pulse pressure,as well as triglycerides,cholesterol,fasting blood glucose levels,of the research subjects were collected.Enzyme-linked immunosorbent assay was used to detect the levels of serum sP-selectin and sE-selectin.Electrochemiluminescence was used to measure fasting insulin level,and insulin resistance index was calculated.Pearson correlation analysis was used to investigate the correlation of serum sP-selectin and sE-selectin levels with fasting insulin level and insulin resistance index in T2DM patients.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum sP-selectin and sE-selectin in EH with T2DM.Results Compared with the control group,the systolic blood pressure,diastolic blood pressure,pulse pressure,and serum triglycerides,cholesterol,fasting blood glucose levels significantly increased in the non-T2DM group and T2DM group(P<0.05).Compared with the non-T2DM group,serum triglycerides,cholesterol and fasting blood glucose levels significantly increased in the T2DM group(P<0.05).The serum sP-selectin and sE-selectin levels,fasting insulin level,and insulin resistance index in the control group<non-T2DM group<T2DM group,and the comparison between any two groups showed significantly significant differences(P<0.05).The Pearson correlation analysis results showed that the levels of

关 键 词：原发性高血压 2型糖尿病 可溶性P-选择素 可溶性E-选择素 空腹胰岛素 胰岛素抵抗指数 

分 类 号：R544.11[医药卫生—心血管疾病] R587.1[医药卫生—内科学]