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
吴玲 1李静静 1龚源 1奚超 1李航 1范文杰1
作者信息
- 1. 宣城市中心医院内分泌科,安徽,宣城 242000
- 折叠
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.
Abstract
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 ApoB/ApoA1 ratio can offer guidance for clinical treatment.
关键词
2型糖尿病/微血管并发症/ApoB/ApoA1比值/载脂蛋白BKey words
T2DM/Microvascular complications/ApoB/ApoA1 ratio/ApoB引用本文复制引用
出版年
2024
NETL
NSTL
万方数据