血清CREB、CTRP9与2型糖尿病及胰岛素抵抗的关联分析  

Correlation analysis of serum CREB,CTRP9 with type 2 diabetes mellitus and insulin resistance

作　　者：徐焕焕 王高雷 赵凤娇 刘艳 刘娟 XU Huan-huan;WANG Gao-lei;ZHAO Feng-jiao(Department of Laboratory Medicine,Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi'an Shaanxi 710000,China;Michaelis Internal Medicine,Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi'an Shaanxi 710000,China)

机构地区：[1]陕西省中医医院检验科,陕西西安710000 [2]陕西省中医医院米氏内科,陕西西安710000 [3]安康市中医医院检验科,陕西安康725000

出　　处：《临床和实验医学杂志》2025年第6期609-613,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西卫生健康科研基金项目(编号:2021E013)。

摘　　要：目的分析血清环磷酸腺苷反应元件结合蛋白(CREB)、C1q肿瘤坏死因子相关蛋白9(CTRP9)与2型糖尿病(T2DM)及胰岛素抵抗的关联。方法回顾性选取2022年1月至2023年1月陕西省中医医院收治的150例T2DM患者作为研究对象,纳入T2DM组;另选取同期150名健康志愿者作为非T2DM组。比较两组的临床资料[性别、年龄、体重指数、舒张压、收缩压、总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(GHb)水平]、血清CREB、CTRP9表达水平;建立受试者操作特征(ROC)曲线分析血清CREB、CTRP9对T2DM发病的预测价值。并比较两组患者胰岛素抵抗相关指标[空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]表达水平,采用Pearson相关性分析CREB、CTRP9与胰岛素抵抗的相关性。采用多因素Logistic回归分析探讨T2DM患者胰岛素抵抗的影响因素。结果T2DM组与非T2DM组的性别、年龄、舒张压、收缩压、总胆固醇、HDL-C比较,差异均无统计学意义(P>0.05);T2DM组的体重指数、甘油三酯、LDL-C、GHb分别为(25.23±3.55)kg/m^(2)、(1.42±0.25)mmol/L、(1.41±0.36)mmol/L、(10.17±1.64)%,均高于非T2DM组[(21.81±2.62)kg/m^(2)、(1.12±0.16)mmol/L、(1.12±0.15)mmol/L、(5.86±0.64)%],差异均有统计学意义(P<0.05)。T2DM组血清CREB水平为(8.45±1.26)μg/mL,高于非T2DM组[(2.36±0.64)μg/mL],CTRP9为(131.56±15.66)ng/mL,低于非T2DM组[(178.64±20.67)ng/mL],差异均有统计学意义(P<0.05)。CREB、CTRP9预测T2DM发病的曲线下面积(AUC)分别为0.925、0.883。T2DM组FBG、FINS、HOMA-IR水平均高于非T2DM组,差异均有统计学意义(P<0.05)。血清CREB与FBG、FINS、HOMA-IR均呈正相关(P<0.05);CTRP9与FBG、FINS、HOMA-IR均呈负相关(P<0.05)。Logistic回归分析结果表明,体重指数、LDL-C、GHb、CREB、CTRP9均为T2DM患者胰岛素抵抗的影响因素(P<0.05)。结论与健康人群相比,T2DM患者血清CREB水平明�Objective To analyze the relationship between serum cyclic adenosine monophosphate response element binding protein(CREB),C1q tumor necrosis factor related protein 9(CTRP9),type 2 diabetes mellitus(T2DM)and insulin resistance.Methods A total of 150 patients with T2DM admitted to Shaanxi Provincial Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were retrospectively selected as the study subjects and included in the T2DM group.Another 150 healthy volunteers were selected at the same time as the non-T2DM group.The clinical data[gender,age,body mass index,diastolic blood pressure,systolic blood pressure,total cholesterol,triglyceride,low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),glycosylated hemoglobin(GHb)levels],serum CREB and CTRP9 expression levels were compared between the two groups.The predictive value of serum CREB and CTRP9 for the incidence of T2DM was analyzed by establishing a receiver operating characteristic(ROC)curve.And the expression levels of insulin resistance related indexes[fasting blood glucose(FBG),fasting insulin(FINS),insulin resistance index(HOMA-IR)]were compared between the two groups.The correlation between CREB,CTRP9 and insulin resistance was analyzed by Pearson correlation analysis.The influencing factors of insulin resistance in patients with T2DM were analyzed by multivariate Logistic regression analysis.Results There were no significant differences in gender,age,diastolic blood pressure,systolic blood pressure,total cholesterol and HDL-C between the T2DM group and the non-T2DM group(P>0.05).The body mass index,triglyceride,LDL-C and GHb in the T2DM group were(25.23±3.55)kg/m^(2),(1.42±0.25)mmol/L,(1.41±0.36)mmol/L and(10.17±1.64)%,respectively,which were higher than those in the non-T2DM group[(21.81±2.62)kg/m^(2),(1.12±0.16)mmol/L,(1.12±0.15)mmol/L,(5.86±0.64)%],and the differences were statistically significant(P<0.05).The level of serum CREB in the T2DM group was(8.45±1.26)μg/mL,which was higher than t

关 键 词：环磷酸腺苷反应元件结合蛋白 C1q肿瘤坏死因子相关蛋白9 2型糖尿病 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]