镍纹蛋白样蛋白、可溶性髓样细胞触发受体-1水平与2型糖尿病患者颈动脉粥样硬化程度的相关性

Correlation between serum METRNL,sTREM-1 levels and carotid atherosclerosis in type 2 diabetes mellitus patients

目的 探究镍纹蛋白样蛋白(METRNL)、可溶性髓样细胞触发性受体1(sTREM-1)水平与2型糖尿病(T2DM)患者颈动脉粥样硬化(CAS)严重程度的关系。方法 选取2021年12月—2023年12月承德市中心医院T2DM患者235例,根据是否伴有CAS分为CAS组(126例)和对照组(109例)。将CAS组根据CAS的严重程度细分为3个亚组[内膜中层厚度(IMT)增厚组(26例)、斑块形成组(41例)、颈动脉狭窄组(59例)]。收集所有患者临床资料和实验室指标检测结果,同时检测血清METRNL、sTREM-1水平。采用Spearman相关分析评估血清METRNL、sTREM-1与CAS严重程度的相关性。采用多因素Logistic回归分析评估CAS严重程度的影响因素。结果 与对照组比较,CAS组血清METRNL水平显著降低(P<0.05),血清sTREM-1水平显著升高(P<0.05)。IMT增厚组、斑块形成组、颈动脉狭窄组血清METRNL水平依次降低(P<0.001),sTREM-1水平依次升高(P<0.001)。METRNL与CAS严重程度呈负相关性(rs=-0.422,P<0.05),sTREM-1与CAS严重程度呈正相关(rs=0.535,P<0.05)。高血压史、sTREM-1、糖化血红蛋白(Hb A1c)、低密度脂蛋白胆固醇(LDL-C)是CAS严重程度(颈动脉狭窄)的危险因素[比值比(OR)值分别为3.354、2.165、1.642、1.943,95%可信区间(CI)分别为1.580~7.119、1.296~3.618、1.238~2.177、1.188~3.178,P<0.05],METRNL是保护因素(OR=0.768,95%CI为0.640~0.922,P<0.05)。结论 T2DM伴CAS患者血清METRNL水平降低,sTREM-1水平升高,与CAS严重程度密切相关。

Objective To investigate the correlation between serum meteorin-like protein(METRNL),soluble triggering receptor expression on myeloid cell-1(sTREM-1)levels and the degree of carotid atherosclerosis(CAS)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 235 T2DM patients from Chengde Central Hospital from December 2021 to December 2023 were enrolled.T2DM patients were classified into CAS group(126 cases)and control group(109 cases)based on whether they had CAS.The clinical data and laboratory determination results were collected,and the levels of serum METRNL and sTREM-1 were determined.Spearman method was used to analyze the correlation between serum METRNL,sTREM-1 levels and the degree of CAS.Multivariate Logistic regression was used to analyze the factors for the degree of CAS.Results Compared with control group,serum METRNL level in CAS group was decreased(P<0.05),while serum sTREM-1 level was increased(P<0.05).Serum METRNL level in IMT thickening group,plaque formation group and carotid artery stenosis group were decreased in turn(P<0.001),while sTREM-1 level was increased in turn(P<0.001).There was a negative correlation between serum METRNL and the severity of CAS in CAS patients(rs=-0.422,P<0.05),and there was a positive correlation between sTREM-1 and the severity of CAS(rs=0.535,P<0.05).History of hypertension,sTREM-1,glycated hemoglobin A1c(HbA1c)and low-density lipoprotein cholesterol(LDL-C)were risk factors for CAS severity(carotid artery stenosis)[odds ratios(OR)were 3.354,2.165,1.642 and 1.943,95%confidence intervals(CI)were 1.580-7.119,1.296-3.618,1.238-2.177 and 1.188-3.178],and METRNL was a protective factor(OR=0.768,95%CI 0.640-0.922,P<0.05).Conclusions Serum METRNL level is decreased and sTREM-1 level is increased in T2DM patients with CAS,which is related to the degree of CAS.