摘要
目的 研究血清晚期糖基化终末产物(AGEs)、爱帕琳肽(Apelin)、网膜素-1(Omentin-1)与2型糖尿病(T2DM)患者血糖在目标范围内时间(TIR)的相关性及对并发微血管病变的预警能力.方法 前瞻性选取2021年5月至2024年6月新乡医学院第一附属医院收治的120例T2DM患者纳入研究,根据是否并发微血管病变分为并发组(n=52)和未并发组(n=68).比较两组患者的基线资料和血清AGEs、Apelin、Omentin-1水平,采用Pearson相关性分析血清AGEs、Apelin、Omentin-1与TIR的相关性,采用多因素Logistic回归分析血清AGEs、Apelin、Omentin-1对T2DM并发微血管病变的影响,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)评估血清AGEs、Apelin、Omentin-1对并发微血管病变的预警能力.结果 并发组患者的T2DM病程为(9.01±1.35)年,明显长于未并发组的(8.53±1.24)年,糖化血红蛋白为(8.92±0.50)%,明显高于未并发组的(7.15±0.78)%,TIR为(46.73±10.22)%,明显低于未并发组的(68.82±7.61)%,差异均有统计学意义(P<0.05);并发组和未发生组患者的血清AGEs[(20.35±6.74)μg/mL vs(14.10±4.69)μg/mL]、Apelin[(6.20±2.03)ng/mL vs(4.19±1.27)ng/mL]比较,并发组明显高于未并发组,Omentin-1[(50.87±14.56)ng/mL vs(72.56±22.97)ng/mL]比较,并发组明显低于未发生组,差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,血清AGEs、Apelin与TIR呈负相关(r=-0.759、-0.762,P<0.05),Omentin-1与TIR呈正相关(r=0.733,P<0.05);多因素Logistic回归分析结果显示,血清AGEs、Apelin、Omentin-1是T2DM并发微血管病变的独立相关影响因素(P<0.05);ROC曲线结果显示,血清AGEs、Apelin、Omentin-1单独及联合预测患者并发微血管病变的曲线下面积分别为0.787、0.798、0.796、0.935,联合预测价值更大.结论 T2DM患者血清AGEs、Apelin、Omentin-1水平异常表达与TIR、并发微血管病变有关,三者联合有助于提高T2DM患者并发微血管病变的预测效能.
Abstract
Objective To study the correlation of serum advanced glycation end products(AGEs),Apelin,Omentin-1 with time in range(TIR,the time of blood glucose within the target range)in patients with type 2 diabetes mellitus(T2DM),as well as their ability to warn of concurrent microvascular complications.Methods A prospective study was conducted to select 120 patients with T2DM admitted to the First Affiliated Hospital of Xinxiang Medical University from May 2021 to June 2024.They were divided into a concurrent group(n=52)and a non-concurrent group(n=68)based on whether they had concurrent microvascular disease.The baseline data and serum levels of AGEs,Ape-lin,and Omentin-1 were compared between the two groups of patients.Pearson correlation analysis was used to analyze the correlation between serum AGEs,Apelin,Omentin-1 and TIR.Multivariate logistic regression analysis was used to analyze the effect of serum AGEs,Apelin,and Omentin-1 on T2DM complicated with microvascular disease.The receiv-er operating characteristic(ROC)curve and area under the curve(AUC)were used to evaluate the predictive ability of serum AGEs,Apelin,and Omentin-1 for the development of microvascular disease.Results The duration of T2DM in the concurrent group was(9.01±1.35)years,which was significantly longer than(8.53±1.24)years in the non-concurrent group;the glycosylated hemoglobin was(8.92±0.50)%,which was significantly higher than(7.15±0.78)%in the non-concurrent group;the TIR was(46.73±10.22)%,which was significantly lower than(68.82±7.61)%in the non-con-current group;the differences were statistically significant(P<0.05).The serum AGEs and Apelin in the concurrent group were significantly higher than those in the non-concurrent group,while the serum Omentin-1 in the concurrent group was significantly lower than that in the non-concurrent group,with statistically significant differences(P<0.05):AGEs,(20.35±6.74)μ g/mL vs(14.10±4.69)μ g/mL;Apelin,(6.20±2.03)ng/mL vs(4.19±1.27)ng/mL;Omentin-1,(50.87±14.56)ng/mL vs(72.56±22.97)ng/mL.Pearson correlation analysis showed that serum AGEs and Apelin were negatively correlated with TIR(r=-0.759,-0.762,P<0.05),while Omentin-1 was positively correlated with TIR(r=0.733,P<0.05).The results of the multivariate logistic regression analysis indicated that serum levels of AGEs,Apelin,and Omentin-1 are independently associated with the development of microvascular complications in patients with T2DM(P<0.05).The ROC curve results showed that the areas under the curve for serum AGEs,Apelin,Omentin-1,and their combination in predicting the development of microvascular complications in patients were 0.787,0.798,0.796,and 0.935,respectively,with the combination having greater predictive value.Conclusion The abnormal expression of serum AGEs,Apelin,and Omentin-1 levels in T2DM patients is associated with TIR and concurrent microvascular dis-ease.The combination of the three is helpful to improve the predictive efficacy of T2DM patients with concurrent micro-vascular disease.
维普
万方数据