摘要
目的:探讨血清血小板内皮细胞粘附分子1（PECAM-1）、沉默信息调节因子2相关酶1（Sirt1）水平与2型糖尿病（T2DM）患者颈动脉粥样硬化（CAS）的关系。方法:选取2021年1月~2022年2月青岛市海慈医院收治的165例T2DM患者（T2DM组），根据颈动脉内中膜厚度（CIMT）分为CAS组48例和非CAS组117例，选取同期61例体检健康者（对照组），采用酶联免疫吸附法检测血清PECAM-1、Sirt1水平。比较T2DM组与对照组的血清PECAM-1、Sirt1水平，采用多因素Logistic回归分析T2DM患者CAS的影响因素，多因素Logistic回归分析T2DM患者CAS的影响因素，受试者工作特征（ROC）曲线分析血清PECAM-1、Sirt1水平预测T2DM患者CAS的价值。结果:与对照组比较，T2DM组血清PECAM-1水平更高，Sirt1水平更低（P＜0.05）。T2DM患者血清PECAM-1水平与CIMT呈正相关，Sirt1水平与CIMT呈负相关（rs＝0.789、-0.785，P均＜0.001）。T2DM病程（OR＝1.483，95％CI：1.090~2.017）、吸烟（OR＝1.408，95％CI：1.054~1.881）、糖化血红蛋白A1c（HbA1c）（OR＝2.900，95％CI：1.324~6.350）、低密度脂蛋白胆固醇（LDL-C）（OR＝1.474，95％CI：1.182~1.838）、PECAM-1（OR＝1.540，95％CI：1.191~1.990）为T2DM患者CAS的独立危险性因素，Sirt1（OR＝0.397，95％CI：0.256~0.617）为独立保护性因素（P＜0.05）。血清PECAM-1、Sirt1水平单独与联合预测T2DM患者CAS的曲线下面积（AUC）分别为0.795、0.797、0.893，血清PECAM-1、Sirt1水平联合预测T2DM患者CAS的AUC大于二者单独预测（P＜0.05）。结论:T2DM患者血清PECAM-1水平升高，Sirt1水平降低，为CAS发生的独立影响因素，可作为T2DM患者CAS的辅助预测指标。
Abstract
Objective:To investigate the relationship between serum platelet endothelial cell adhesion molecule 1 (PECAM-1) and silent information regulator factor 2-related enzyme 1 (Sirt1) levels and carotid atherosclerosis (CAS) in patients with type 2 diabetes mellitus (T2DM).Methods:A total of 165 patients with T2DM admitted to our hospital from January 2021 to February 2022 (T2DM group) were selected and divided into either a CAS group (48 cases) or a non-CAS group (117 cases) according to the carotid intima-media thickness (CIMT), and 61 healthy individuals who underwent physical examination ring the same period were selected as a control group. Serum PECAM-1 and Sirt1 levels were measured by enzyme-linked immunosorbent assay and compared between the T2DM group and the control group. Multi-factor logistic regression was used to identify the factors influencing CAS in T2DM patients. The clinical value of serum PECAM-1 and Sirt1 levels in predicting CAS in T2DM patients was assessed by receiver operating characteristic (ROC) curve analysis.Results:Compared with the control group, serum PECAM-1 level was higher and Sirt1 level was lower in the T2DM group (P＜0.05). Serum PECAM-1 levels were positively correlated with CIMT and Sirt1 levels were negatively correlated with CIMT in T2DM patients (rs=0.789 and -0.785, respectively; P＜0.001 for both). The duration of T2DM (odds ratio [OR]=1.483, 95% confidence interval [CI]: 1.090~2.017), smoking (OR=1.408, 95% CI: 1.054~1.881), glycated hemoglobin A1c (HbA1c) (OR=2.900, 95% CI: 1.324~6.350), low-density lipoprotein cholesterol (LDL-C) (OR=1.474, 95% CI: 1.182~1.838), and PECAM-1 (OR=1.540, 95% CI: 1.191~1.990) were independent risk factors for CAS in patients with T2DM, and Sirt1 (OR=0.397, 95% CI: 0.256~0.617) was an independent protective factor (P＜0.05). The area under the curve (AUC) values of serum PECAM-1 and Sirt1 levels alone and in combination to predict CAS in T2DM patients were 0.795, 0.797, and 0.893, respectively, and the AUC of serum PECAM-1 and Sirt1 levels in combination to predict CAS in T2DM patients was greater than that of either of them alone (P＜0.05).Conclusion:Increased serum PECAM-1 levels and decreased Sirt1 levels in T2DM patients are independent influencing factors for the occurrence of CAS and can be used as an auxiliary predictor of CAS in T2DM patients.
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