Lp-PLA2、S-100B蛋白水平联合检测在糖尿病周围神经病变中的诊断价值

Diagnostic value of combined detection of Lp-PLA2 and S-100B protein levels in diabetic peripheral neuropathy

目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)、S-100B蛋白水平联合检测在糖尿病周围神经病变(DPN)中的诊断价值。方法回顾性分析2021年10月至2022年9月在东莞市水乡中心医院接受治疗的50例DPN患者的临床资料,并将其作为神经病变组,按照1∶1配对原则选择50例单纯糖尿病患者作为糖尿病组。另选取同期该院体检健康者50例作为对照组。收集3组的临床资料,采用免疫定量法检测血清Lp-PLA2、S-100B蛋白水平,Logistic回归分析DPN发生的影响因素,受试者工作特征(ROC)曲线评估血清Lp-PLA2、S-100B表达水平对DPN的诊断效能。结果各组收缩压、糖尿病病程、糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、空腹血糖、运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)比较,差异均有统计学意义(P<0.05)。神经病变组的血清Lp-PLA2、S-100B水平显著高于糖尿病组和对照组(P<0.05),糖尿病组的血清Lp-PLA2、S-100B水平显著高于对照组(P<0.05)。MNCV、SNCV是影响DPN发生的独立保护因素,而Lp-PLA2、S-100B是影响DPN发生的独立危险因素(P<0.05)。血清Lp-PLA2、S-100B单独及联合诊断DPN的曲线下面积分别为0.847、0.780和0.906,灵敏度分别为72.92%、68.75%和83.33%,特异度分别为88.37%、79.07%和87.02%,二者联合检测优于Lp-PLA2、S-100B各自单独预测(P<0.05)。结论血清Lp-PLA2、S-100B在DPN患者中表达异常,二者联合可提高DPN的诊断效能。

Objective To investigate the diagnostic value of lipoprotein-associated phospholipase A2(Lp-PLA2)and S-100B protein levels in diabetic peripheral neuropathy(DPN).Methods The clinical data of 50 DPN patients treated in Dongguan Water Town Central Hospital from October 2021 to September 2022 were retrospectively analyzed,and they were selected as the neuropathy group.Meanwhile,50 patients with simple diabetes were selected as the diabetes group according to the 1∶1 pairing principle.Another 50 healthy subjects were selected as control group.Clinical data of the 3 groups were collected,serum Lp-PLA2 and S-100B protein levels were detected by immunoquantitative method.Logistic regression was used to analyze the influencing factors of DPN occurrence and receiver operating characteristic(ROC)curve was applied to analyze the diagnostic efficacy of serum Lp-PLA2 and S-100B expression levels on DPN.Results There were statistically significant differences in systolic blood pressure,course of diabetes,glycosylated hemoglobin,total cholesterol,triglyceride,low-density lipoprotein cholesterol(LDL-C),fasting blood glucose,motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)among the groups(P<0.05).The serum Lp-PLA2 and S-100B levels in neuropathy group were significantly higher than those in diabetes group and the control group(P<0.05),and the serum Lp-PLA2 and S-100B levels in diabetes group were significantly higher than those in control group(P<0.05).MNCV and SNCV were independent protective factors for DPN,while Lp-PLA2 and S-100B were independent risk factors for DPN(P<0.05).The area under curve of serum Lp-PLA2 and S-100B alone and in combination for the diagnosis of DPN were 0.847,0.780 and 0.906,the sensitivity were 72.92%,68.75%and 83.33%,and the specificity were 88.37%,79.07%and 87.02%,respectively.The combined prediction of Lp-PLA2 and S-100B was better than that of LP-PLA2 and S-100B alone(P<0.05).Conclusion Serum Lp-PLA2 and S-100B are abnormally expressed in DPN patients,and their combination could improve the diagnostic efficiency of DPN.