PPARγ、AOPP和胱抑素C对老年2型糖尿病动脉粥样硬化的诊断价值

Significance of serum peroxisome proliferator activator receptor γ,advanced oxidation protein product and cystatin C in diagnosis of atherosclerosis in patients with type 2 diabetes mellitus

目的探讨血过氧化物酶体增殖因子活化受体γ(PPARγ)、胱抑素C和晚期氧化蛋白产物(AOPP)对老年2型糖尿病(T2DM)患者动脉粥样硬化(AS)的诊断价值。方法 T2DM伴AS患者80例,年龄≥75岁。根据肱-踝动脉脉搏波速度(baPWV)将80例患者均分为两组。轻度AS组baPWV 1400~2000cm/s,重度AS组baPWV>2000cm/s。应用RT-PCR检测患者血浆PPARγ基因表达,ELISA双抗体夹心法测定血清AOPP水平,免疫比浊法测定血清胱抑素C水平。结果重度AS组血浆PPARγ表达高于轻度AS组(P<0.01)。两组血清胱抑素C与AOPP水平差异无统计学意义(P>0.05)。PPARγ对重度AS具有较高的诊断价值(AUC=0.850)。联合检测PPARγ、胱抑素C和AOPP对判断AS有更高的诊断价值[AUC=0.961,95%CI(0.916~1.000),灵敏度=0.975]。结论血PPARγ、AOPP及胱抑素C与老年T2DM患者AS密切相关。

Objective To explore the significance of serum peroxisome proliferator activator receptor 7（PPART）, advanced oxidation protein product（AOPP） and cystatin C in the diagnosis of atherosclerosis（AS） in the patients with type 2 diabetes mellitus（T2DM）. Methods Eighty T2DM patients（aged≥75 years old） with AS were equally assigned into two groups of A[（brachial-ankle pulse wave velocity（baPWV） 1400-2000 cm/s] and B（baPWV〉2000 cm/s）. Plasma expression of PPAR7 gene was detected by RT-PCR. Serum level of AOPP was detected by double-antibody sandwich enzyme-linked immunosorbent assay. Serum level of cystatin C was detected by immunonephelometry. Results Plasma expression of PPAR7 gene was higher in group B than that in group A（P〈0. 01）. There were no significant differences in serum levels of AOPP and cystatin C between two groups（P〉0. 05）. PPARγhad a higher diagnostic value for severe AS（AUC=0. 850）. Combined detection of PPART, cystatin C and AOPP had a quite high diagnostic value for AS[AUC= 0. 961,95%CI（0. 916-1. 000）, sencitivity=0. 975]. Conclusion The levels of PPART, cystatin C and AOPP are colsely related to AS in elderly T2DM patients.