摘要
目的 评估血清全段成纤维细胞生长因子(FGF23)对2型糖尿病患者冠状动脉钙化的预测价值.方法 选择2022年1月至2023年1月门诊及住院的2型糖尿病患者共86例为2型糖尿病患者组,选择年龄、性别匹配的80例健康体检者为对照组.比较两组患者的临床资料,血压、血脂、肾功能、钙磷代谢指标,血清FGF23及冠状动脉钙化发生率等.分析血清FGF23及碱性磷酸酶(AKP)对2型糖尿病患者冠状动脉钙化的预测价值.结果 2型糖尿病患者组的糖化血红蛋白(HbA1c)、血清FGF23、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三脂(TG)、尿蛋白肌酐比值(UACR)、血磷、钙磷乘积、AKP以及冠状动脉钙化发生率均明显高于对照组,高密度脂蛋白胆固醇(HDL-C)低于对照组,差异均有统计学意义(t分别=6.32、5.12、3.65、4.25、5.78、2.47、3.45、5.12、2.45、2.47、3.89,x2=3.46,t=-2.46,P 均＜0.05).多元线性回归分析,logFGF23 与吸烟、血磷、AKP、UACR、冠状动脉钙化有相关性(t分别=9.02、5.69、6.35、7.65、12.89,P均＜0.05).受试者工作特征曲线(ROC)结果显示,血清FGF23预测2型糖尿病患者合并冠状动脉钙化的曲线下面积为0.70(95％CI 0.62～0.78),当检测的截点为305.52 μg/mL时,其灵敏度及特异度分别为76.73％及68.12％.血清AKP预测2型糖尿病患者合并冠状动脉钙化的曲线下面积为0.62(95％CI 0.55～0.70),当检测的截点为67.15 mmol/L,其灵敏度及特异度分别为66.52％及58.26％.结论 2型糖尿病患者有更高的血清FGF23水平,血清FGF23对2型糖尿病患者合并冠状动脉钙化具有较好的预测价值.
Abstract
Objective To evaluate the predictive value of serum total fibroblast growth factor 23(FGF23)on coronary artery calcification in patients with type 2 diabetes mellitus.Methods A total of 86 outpatient and inpatient patients with type 2 diabetes complicated with from January 2022 to January 2023 were selected as the type 2 diabetes mellitus group,and 80 healthy subjects matched by age and sex were selected as the control group.The clinical data,blood pres-sure,blood lipids,renal function,calcium and phosphorus metabolism indexes,serum FGF23,and incidence of coronary artery calcification were compared between the two groups.The predictive value of serum FGF23 and alkaline phospha-tase on coronary artery calcification(AKP)in patients with type 2 diabetes mellitus were analyzed.Results The levels of glycated hemoglobin(HbA1c),FGF23,systolic blood pressure(SBP),diastolic blood pressure(DBP),total cholester-ol(TC),low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),urine albumin-to-creatinine ratio(UACR),blood phosphate,calcium-phosphate product,alkaline phosphatase(AKP),and the incidence of coronary artery calcifica-tion in type 2 diabetes mellitus patients were significantly higher than those of the control group,the blood high density lipoprotein cholesterol(HDL-C)was lower than that of the control group,and the differences were statistically signifi-cant(t=6.32,5.12,3.65,4.25,5.78,2.47,3.45,5.12,2.45,2.47,3.89,x2=3.46,t=-2.46,P＜0.05).Multivariate regres-sion analysis showed that logFGF23 was positively correlated with smoking,blood phosphate,AKP,UACR,and coronary artery calcification(t=9.02,5.69,6.35,7.65,12.89,P＜0.05).The ROC curve results showed that the area under the curve of serum FGF23 predicting cor-onary artery calcification in patients with type 2 dia-betes mellitus was 0.70(95％CI 0.62-0.78),with a sensitivity and specificity of 76.73％and 68.12％,respectively,when the cutoff value was 305.52 μg/mL.For AKP,the area under the curve was 0.62(95％CI 0.55-0.70),and when the cutoff value of 67.15 mmol/L,the sensitivity and specificity were 66.52％and 58.26％,respectively.Conclusion Patients with type 2 diabetes mellitus have higher serum FGF23.Serum FGF23 has a good predictive value in patients with type 2 diabetes mellitus complicated with coronary artery calcification.
维普
万方数据