目的 探讨单核细胞与高密度脂蛋白胆固醇比值(monocyte to high-density lipoprotein cholesterol ratio,MHR)与2型糖尿病(type 2 diabetes mellitus,T2DM)患者颈动脉粥样硬化(carotid atherosclerosis,CAS)病变的相关性.方法 选取2020年6月～2023年6月于湖北医药学院附属随州医院内分泌科收治的T2DM患者457例,根据颈动脉内-中膜厚度(carotid intima-media thickness,CIMT)分为3组,其中CIMT正常组104例,CIMT增厚组113例,CAS斑块组240例.比较各组的一般资料、生化指标及MHR,并分析MHR与T2DM患者其他指标的相关性,Logistic回归分析评估T2DM患者CAS斑块形成的影响因素,受试者工作特征(receiver operating characteristic,ROC)曲线分析MHR对T2DM患者CAS斑块形成的预测价值.结果 CAS斑块组的MHR高于CIMT正常组、CIMT增厚组(P＜0.05).Spearman相关性分析结果显示,在T2DM患者中,MHR与体重指数(body mass index,BMI)、中性粒细胞(neutrophil,NEU)、淋巴细胞(lymphocyte,LY)、单核细胞(monocyte,MO)、肌酐(creatinine,Cr)、尿酸(uric acid,UA)呈正相关,与糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)呈负相关(P＜0.05).Logistic 回归分析结果显示,MHR 是 T2DM 患者CAS斑块形成的危险因素.ROC曲线分析结果显示,MHR预测T2DM患者CAS斑块形成的曲线下面积(area under the curve,AUC)为0.593(95％CI:0.541～0.645,P=0.001),最佳截断值为0.34时,其诊断CAS斑块形成的敏感度为63.3％,特异性为51.2％.结论 MHR与T2DM患者CAS病变密切相关,且对CAS斑块形成有一定的预测价值.
Correlation between MHR and Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus
Objective To investigate the correlation between monocyte to high-density lipoprotein cholesterol ratio(MHR)and ca-rotid atherosclerosis(CAS)in patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 457 cases of T2DM admit-ted to the Department of endocrinology,Suizhou Hospital Affiliated to Hubei University of Medicine from June 2020 to June 2023 were ret-rospectively collected.According to the measured carotid intima-media thickness(CIMT),the patients were divided into three groups:normal CIMT group(n=104),CIMT thickening group(n=113)and CAS plaque group(n=240).The general data,biochemical in-dexes and MHR of each group were compared,and the correlation between MHR and other indexes in T2DM patients was analyzed.Logis-tic regression analysis was used to analyze the influencing factors of CAS plaque formation in T2DM patients.The receiver operating char-acteristic(ROC)curve was used to analyze the predictive value of MHR in CAS plaque formation in T2DM patients.Results The MHR of CAS plaque group was higher than that of CIMT normal group and CIMT thickening group(P＜0.05).Spearman correlation analysis showed that in patients with T2DM,MHR was positively correlated with body mass index(BMI),neutrophil(NEU),lymphocyte(LY),monocyte(MO),creatinine(Cr)and uric acid(UA),and negatively correlated with glycosylated hemoglobin A1c(HbA1c),total cho-lesterol(TC)and high density lipoprotein cholesterol(HDL-C)(P＜0.05).logistic regression analysis showed that MHR was a risk factor for CAS plaque formation in patients with T2DM.ROC curve analysis showed that the area under the curve(AUC)of MHR for pre-dicting CAS plaques in T2DM patients was 0.593(95％CI:0.541-0.645,P=0.001),and the optimal cut-off value was 0.34,the sensitivity and specificity for the diagnosis of CAS were 63.3％and 51.2％.Conclusion MHR is closely related to CAS lesions in pa-tients with T2DM,and has a certain predictive value for the formation of CAS plaques.
Type 2 diabetes mellitusCarotid atherosclerosisMonocyte to high-density lipoprotein cholesterol ratio
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