T2DM患者血清CTRP3和Ficolin-3及MIP-1α水平及与患者并发DPN的相关性

Serum CTRP3,Ficolin-3,MIP-1αlevels in T2DM patients and their correlation with concurrent DPN

目的探究2型糖尿病(T2DM)患者血清补体C1q肿瘤坏死因子相关蛋白3(CTRP3)、纤维凝胶蛋白-3(Ficolin-3)、巨噬细胞炎症蛋白-1α(MIP-1α)水平及与患者并发糖尿病周围神经病变(DPN)的相关性。方法选取2019年1月-2022年5月在北京核工业医院接受治疗的80例T2DM患者,其中单纯T2DM患者(T2DM组)56例,T2DM合并DPN患者(T2DM合并DPN组)24例;另选取同期体检的健康人员50人作为对照组。比较3组研究对象临床各指标差异,logistic回归分析影响T2DM患者并发DPN的危险因素,受试者工作特征(ROC)曲线及曲线下面积(AUC)分析血清CTRP3、Ficolin-3、MIP-1α对于并发DPN的诊断价值。结果3组研究对象临床一般资料、肝肾功能指标比较差异无统计学意义(P>0.05);3组研究对象空腹血糖(FBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、CTRP3、Ficolin-3、MIP-1α水平比较差异均有统计学意义(F=15.569、14.229、17.321、10.116、12.415、8.680、10.357、14.806、8.612、9.577,P均<0.05)。T2DM组与T2DM合并DPN组患者病程、感觉神经传导速度(SNCV)、运动神经传导速度(MNCV)比较差异均有统计学意义(t=8.232、9.683、5.925,P均<0.05)。相关性分析结果显示,血清CTRP3、Ficolin-3、MIP-1α水平与T2DM合并DPN患者SNCV、MNCV存在正相关性(rSNCV=0.337、0.415、0.276,rMNCV=0.340、0.409、0.295,P均<0.05)。Logistic回归分析显示,CTRP3、Ficolin-3、MIP-1α均为T2DM患者并发DPN的危险因素(P<0.05)。ROC曲线结果显示,MIP、Ficolin-3、MIP-1α及三者联合诊断的AUC分别为0.848(95%CI:0.786~0.910)、0.856(95%CI:0.785~0.927)、0.761(95%CI:0.682~0.840)及0.916(95%CI:0.872~0.959)。结论T2DM患者血清中CTRP3、Ficolin-3、MIP-1α水平显著降低,在并发DPN患者中进一步降低,对于T2DM患者并发DPN的临床诊断具有一定价值。

Objective To investigate the levels of serum complement C1q tumor necrosis factor-associated protein 3(CTRP3),Ficolin-3,macrophage inflammatory protein-1α(MIP-1α)in patients with type 2 diabetes mellitus(T2DM)and the correlation with patients with concurrent diabetic peripheral neuropathy(DPN).Methods A total of 80 patients with T2DM treated in Beijing Nuclear Industry Hospital from January 2019 to May 2022 were selected,including 56 patients with T2DM alone and 24 patients with T2DM combined with DPN,and 50 healthy people who received physical examination in our hospital during the same period were selected as the control group.Differences in clinical indicators among the three groups of study subjects were compared,and the risk factors affecting T2DM patients with concomitant DPN were analyzed by logistic regression,and the subject's operating characteristic curve(ROC)and area under the curve(AUC)were analyzed for the diagnostic value of serum CTRP3,Ficolin-3 and MIP-1αfor concomitant DPN.Results There was no statistically significant differences in clinical general information and liver and kidney function indicators among the three groups of study subjects(P>0.05).Fasting blood glucose(FBG),glycated hemoglobin(HbA1c),insulin resistance index(HOMA-IR),total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),CTRP3,Ficolin-3,and MIP-1αwere statistically significant(F=15.569,14.229,17.321,10.116,12.415,8.680,10.357,14.806,8.612,9.577;all P<0.05).The differences in disease duration,sensory nerve conduction velocity(SNCV),and motor nerve conduction velocity(MNCV)between the T2DM alone group and the T2DM combined with DPN group patients were statistically significant(t=9.683,5.925;all P<0.05).Correlation analysis showed that serum CTRP3,Ficolin-3,and MIP-1αlevels were positively correlated with SNCV and MNCV in patients with T2DM combined with DPN(rSNCV=0.337,0.415,0.276;rMNCV=0.340,0.409,0.295;all P<0.05).Logistic regression analysis showed that CTRP3,Ficolin-3,and MIP-1αwere all risk factors for concomitant DPN in patients with T2DM(P<0.05).ROC curve results showed that the AUCs for MIP,Ficolin-3,MIP-1α,and the combined diagnosis of the three were 0.848(95%CI:0.786-0.910),0.856(95%CI:0.785-0.927),0.761(95%CI:0.682-0.840)and 0.916(95%CI:0.872-0.959),respectively.Conclusion The serum levels of CTRP3,Ficolin-3,and MIP-1αwere significantly reduced in T2DM patients and further reduced in patients with concurrent DPN,which could be used for the clinical diagnosis of T2DM patients with concurrent DPN.