摘要
目的探讨血清同型半胱氨酸(Hcy)、载脂蛋白B/载脂蛋白A1(ApoB/ApoA1)与尿白蛋白/肌酐比值(UACR)与糖尿病肾病(DKD)患者动脉粥样硬化(AS)及心血管事件(MACE)的关系。方法选取2018年2月至2021年6月收治于阜阳市临泉县人民医院的114例DKD患者作为DKD组,另选取同期60例单纯2型糖尿病作为对照组,分析两组Hcy、ApoB/ApoA1、UACR、AS相关指标[纤维蛋白原(FIB)、D-二聚体、颈动脉内膜中层厚度(IMT)]变化差异;采用Pearson分析DKD患者与疾病相关指标的关系。114例DKD患者随访1年后,按随访期间是否发生MACE分为MACE组和非MACE组;收集所有患者临床资料,分别采用单因素及Logistic回归分析影响DKD患者发生MACE的独立预测因素,并进一步采用ROC曲线分析Hcy、ApoB/ApoA1、UACR单独及联合对DKD患者发生MACE的诊断价值。结果DKD组Hcy、ApoB/ApoA1、UACR、FIB、D-二聚体、IMT水平均高于对照组,差异有统计学意义(t=5.423、9.375、7.011、10.630、18.363、7.867,P<0.05);Pearson相关性分析显示,DKD患者的FIB、D-二聚体、IMT均与Hcy、ApoB/ApoA1、UACR呈正相关关系(P<0.05)。MACE组与非MACE组病程、HAblc、Hcy、ApoB/ApoA1、UACR水平差异均有统计学意义(t=3.502、12.424、7.165、4.233、5.372,P<0.05);Logistic回归分析结果显示,HAblc、Hcy、ApoB/ApoA1、UACR是影响DKD患者发生MACE的独立预测因素(P<0.05)。ROC曲线分析显示,Hcy、ApoB/ApoA1、UACR联合检测DKD患者发生MACE的曲线下的面积最大,为0.796(P<0.05)。结论血清Hcy、ApoB/ApoA1、UACR可以反映DKD患者AS情况,并有望成为评估DKD患者发生MACE的预测指标。
Objective To investigate the relationship between serum homocysteine(Hcy),apoli⁃poprotein B/apolipoprotein A1(ApoB/ApoA1),urinary albumin/creatinine ratio(UACR)and atherosclero⁃sis(AS)and cardiovascular events(MACE)in patients with diabetic kidney disease(DKD).Methods A to⁃tal of 114 patients with DKD admitted to Linquan County People's Hospital of Fuyang City from February 2018 to June 2021 were selected as the DKD group,and 60 patients with simple type 2 diabetes during the same peri⁃od were selected as the control group.The changes of Hcy,ApoB/ApoA1,UACR and AS related indicators[fibrinogen(FIB),D⁃dimer and carotid intima⁃media thickness(IMT)]were analyzed.Pearson was used to an⁃alyze the relationship between DKD patients and disease⁃related indicators.After 1 year of follow⁃up,114 DKD patients were divided into MACE group and non⁃MACE group according to whether MACE occurred during fol⁃low⁃up.The clinical data of all patients were collected,and the independent predictors of MACE in patients with DKD were analyzed by univariate and logistic regression,respectively.The diagnostic value of Hcy,ApoB/ApoA1 and UACR alone and in combination for MACE in patients with DKD was further analyzed by ROC curve.Results The levels of Hcy,ApoB/ApoA1,UACR,FIB,D⁃dimer and IMT in the DKD group were higher than those in the control group(t=5.423,9.375,7.011,10.630,18.363,7.867,P<0.05).Pearson correlation analysis showed that FIB,D⁃dimer and IMT were positively correlated with Hcy,ApoB/ApoA1 and UACR in DKD patients(P<0.05).There were significant differences in the course of disease,HAblc,Hcy,ApoB/ApoA1 and UACR levels between the MACE group and the non⁃MACE group(t=3.502,12.424,7.165,4.233,5.372,P<0.05).Logistic regression analysis showed that HAblc,Hcy,ApoB/ApoA1 and UACR were independent predictors of MACE in DKD patients(P<0.05).The ROC curve analysis showed that the area under the curve of Hcy,ApoB/ApoA1 and UACR combined detection of MACE in DKD patients was the largest,which was 0.796(P<0.05).Conclusion Serum Hcy,ApoB/ApoA1 and UACR can reflect AS in DKD patients,and are expected to be predictors of MACE in DKD patients.
作者
韩士彬
郭东亮
韦梦慈
HAN Shibin;GUO Dongliang;WEI Mengci(Department of Endocrinology,Linquan County People's Hospital,Fuyang City,Anhui Province,236400,China)
出处
《分子诊断与治疗杂志》
2023年第6期1007-1011,共5页
Journal of Molecular Diagnostics and Therapy
基金
阜阳市卫健委青年项目(FY2021-108)。
作者简介
通信作者:郭东亮,E⁃mail:k13966826737@163.com。
