摘要
目的探究糖尿病伴中心性肥胖患者外周血心肌梗死相关转录因子(MIAT)mRNA、糖化血红蛋白(HbA_(1c))表达水平及其对微血管并发症的预测价值。方法前瞻性选取2021年5月—2023年3月于川北医学院第二临床医学院/南充市中心医院内分泌科收治的糖尿病伴中心性肥胖患者212例为观察组,另选同期健康体检者212例为健康对照组,采集所有研究对象的清晨空腹外周血,检测其MIAT mRNA表达、HbA_(1c)水平。对其随访1年,根据患者是否发生微血管并发症分为并发症亚组(n=86)和无并发症亚组(n=126),采用ROC曲线分析患者血MIAT mRNA、HbA_(1c)水平对微血管并发症的预测价值。结果与健康对照组相比,观察组的外周血MIAT mRNA、HbA_(1c)表达水平均升高(t/P=28.299/<0.001,22.952/<0.001)。Logistic回归结果显示,年龄大(OR=1.450,95%CI 1.141~2.093,P=0.016)、BMI高(OR=1.325,95%CI 1.059~1.799,P=0.037)、病程长(OR=2.137,95%CI 1.430~2.786,P<0.001)、高脂血症(OR=2.368,95%CI 1.626~3.439,P<0.001)、空腹血糖高(OR=2.705,95%CI 1.909~5.172,P<0.001)、MIAT mRNA高(OR=2.449,95%CI 1.753~3.652,P<0.001)、HbA_(1c)高(OR=1.934,95%CI 1.329~2.646,P<0.001)均为微血管并发症的风险因素。由ROC曲线分析可得,血MIAT mRNA单独检测的曲线下面积(AUC)为0.719,敏感度为0.767,特异度为0.619;HbA_(1c)单独检测的AUC为0.772,敏感度为0.640,特异度为0.802;血MIAT mRNA和HbA_(1c)联合检测的AUC为0.825,敏感度为0.744,特异度为0.810。结论糖尿病伴中心性肥胖患者外周血MIAT、HbA_(1c)表达水平均有所升高,且两者联合检测对微血管并发症具有较高的预测价值。
Objective To explore the expression levels of myocardial infarction-associated transcription factor(MIAT)mRNA and glycated hemoglobin(HbA_(1c))in peripheral blood of patients with diabetes and central obesity and their predictive value for microvascular complications.Methods Two hundred and twelve patients with diabetes and central obesity admitted to our hospital from May 2021 to March 2023 were prospectively selected as the observation group,and 212 healthy people who underwent physical examination during the same period were selected as the healthy control group.Early morning fasting peripheral blood was collected from all study subjects,and their MIAT mRNA and HbA_(1c) expression levels were detected.The patients were followed up for 1 year and were divided into a complication group(n=86)and a no-complication group(n=126)according to whether they developed microvascular complications.The ROC curve was used to analyze the predictive value of patients'serum MIAT mRNA and HbA_(1c) levels for microvascular complications.Results Compared to the healthy control group,the expression levels of MIAT mRNA and HbA_(1c) were increased in the observation group(t/P=28.299/<0.001,22.952/<0.001).Logistic regression results showed that age(OR=1.450,95%CI 1.141-2.093,P=0.016),BMI(OR=1.325,95%CI 1.059-1.799,P=0.037),disease duration(OR=2.137,95%CI 1.430-2.786,P<0.001),Hyperlipidemia(OR=2.368,95%CI 1.626-3.439,P<0.001),fasting blood glucose(OR=2.705,95%CI 1.909-5.172,P<0.001),MIAT mRNA(OR=2.449,95%CI 1.753-3.652,P<0.001),HbA_(1c)(OR=1.934,95%CI 1.329-2.646,P<0.001)are risk factors for microvascular complications.According to ROC curve analysis,the sensitivity and specificity of serum MIAT mRNA detection alone is 0.767 and 0.619,and the area under curve is 0.719.The sensitivity and specificity of HbA_(1c) detection alone are 0.640 and 0.802.The sensitivity of combined detection of serum MIAT mRNA and HbA_(1c) is 0.744,the specificity is 0.810,and the area under curve is 0.825.Conclusion The expression levels of MIAT and HbA_(1c) in peripheral blood of patients with diabetes mellitus and central obesity increased,and the combined detection of the two had a high predictive value for microvascular complications.
作者
乔彦
易诗琼
滕云
王凤
Qiao Yan;Yi Shiqiong;Teng Yun;Wang Feng(Department of Endocrinology,Second Clinical School of North Sichuan Medical College/Nanchong Central Hospital,Sichuan,Nanchong 637000,China)
出处
《疑难病杂志》
2025年第4期407-411,共5页
Chinese Journal of Difficult and Complicated Cases
基金
四川省自然科学基金(2023NSFSC0731)
南充市基础研究平台项目(23JCYJPT0028)。
关键词
糖尿病
中心性肥胖
心肌梗死相关转录因子
糖化血红蛋白
预测价值
Diabetes
Central obesity
Myocardial infarction-associated transcription factor
Glycosylated hemoglobin
Predictive value
作者简介
通信作者:乔彦,E-mail:qya1983@163.com。
