2型糖尿病患者单核细胞与高密度脂蛋白胆固醇比值预测冠脉病变程度的价值

Predicative value of monocyte to high-density lipoprotein cholesterol ratio in the severity of coronary heart disease in type 2 diabetes

目的:探讨单核细胞与高密度脂蛋白胆固醇比值(MHR)对2型糖尿病患者冠脉病变程度的预测价值。方法:回顾分析广西壮族自治区人民医院200例2型糖尿病合并冠心病患者资料,分为单支病变组(n=95)及多支病变组(n=105),根据Gensini评分评估冠脉狭窄程度,根据MHR中位数分为高MHR组(n=100)和低MHR组(n=100),分析MHR与冠脉病变程度的相关性。结果:高MHR组较低MHR组的糖尿病病史更长、空腹血糖、Gensini评分水平更高。多支病变组较单支病变组MHR和Gensini评分更高,差异有统计学意义(P<0.05)。Logistic回归显示MHR是糖尿病并发冠心病的独立危险因素,差异有统计学意义(OR=5.006,P<0.05)。MHR预测2型糖尿病患者发生严重冠脉病变的灵敏度和特异度分别为64.76%、85.26%,受试者工作特征(ROC)曲线下面积为0.776。结论:MHR对2型糖尿病患者并发严重冠脉病变具有一定的预测价值,高水平的MHR提示患者可能合并严重的冠脉病变。

Objective The aim of the present study was to explore the predictive value of monocyte to high-density lipoprotein cholesterol ratio(MHR)in the severity of coronary heart disease in type 2 diabetes.Method Retrospective analysis of 200 cases of type 2 diabetes with coronary heart disease,then the subjects were divided into single vessel disease group(n=95)and multi-vessel disease group(n=105).According to the Gensini score method,the coronary artery stenosis of the type 2 diabetes was scored.According to the median MHR,the patients were divided into high MHR group(n=100)and low MHR group(n=100),and the correlation between MHR and the degree of coronary artery disease was analyzed.Results The high MHR group had higher fasting blood-glucose,Gensini scores and longer diabetes history than the low MHR group;the multi-vessel disease group had higher MHR level and Gensini scores than the single-vessel disease group,the difference was statistically significant(P<0.05).Logistic analysis showed that,MHR was a risk factor of predicting the severe of coronary heart disease in type 2 diabetes(OR=5.006,P<0.05).MHR had sensitivity and specificity of 64.76%and 85.26%in predicting the severe of coronary heart disease in type 2 diabetic patients,with an area under the curve of 0.776.Conclusion MHR might be a biomarker to predict the severe of coronary heart disease in type 2 diabetes and high MHR level indicate the severe coronary stenosis in diabetes.