血清CA19-9、HbA1c和FFA与代谢综合征的相关性研究

The Correlation of Levels of Serum CA19-9,HbA1c and FFA with Metabolic Syndrom

目的探究血清CA19-9、糖化血红蛋白(HbA1c)和游离脂肪酸(free fat acid, FFA)与代谢综合征(metabolic syndrome,MS)的相关性。方法依据随机数字表法收取2016年3月至2017年9月于我院接受体检的体检者464名,依据中华医学会糖尿病分会代谢综合征研究协作组建议的MS诊断标准分为MS组(109例)和非MS组(355例)。运用受试者工作特征曲线(receiver operating characteristic,ROC)技术分析血清CA19-9、HbA1c和FFA在鉴别诊断MS的临床价值。相关性分析采用Pearson检验。采用Logistic回归分析计算CA19-9、HbA1c和FFA的相对危险度(odds ratio,OR)及其95%置信区间(confidence interval,CI)。结果与非MS组相比,MS组患者在血清CA19-9、HbA1c和FFA水平均显著增高,且差异具有统计学意义(P均<0. 05)。MS患者血清CA19-9与糖尿病史、空腹血糖(fasting blood glucose,FPG)、体重指数(body mass index,BMI)、腰围呈线性关联;血清HbA1c与糖尿病史和FPG呈线性关联;血清FFA水平则分别与BMI和腰围呈线性关联。联合血清CA19-9、HbA1c和FFA在区分MS和非MS的灵敏度为91.5%,特异性为93.0%。多因素Logistic回归分析显示,校正年龄、性别、吸烟、饮酒、糖尿病、高血压、肥胖及各血脂指标等因素影响后,血清高CA19-9、高HbA1c和高FFA是MS的独立危险因素。结论血清CA19-9、HbA1c和FFA三者对MS具有潜在的诊断价值,有望为临床MS患者的诊疗提供新的途径与思路。

Objective To explore the correlation between levels of serum CA19-9,glycosylated hemoglobin(HbA1c)and free fatty acid(FFA)and metabolic syndrome(MS).Methods Using the random number table method,464 people who received physical examination in our hospital from March 2016 to September 2017 were collected for the study.According to the MS diagnostic criteria recommended by the cooperative group in the Diabetes Association of Chinese Medical Association,they were divided into MS group(109 cases)and non-MS group(355 cases).Receiver operating characteristic(ROC)curve was used to test the clinical value of serum CA19-9,HbA1c and FFA in the differential diagnosis of MS in this cohort.Spearman test was used for the correlation analysis.Logistic regression was used to obtain the odds ratios(OR)and their 95%confidence intervals(CI).Results Compared with the non-MS group,the serum levels of CA19-9,HbA1c and FFA in the group MS were significantly higher,(P<0.05).There was a linear correlation between serum CA19-9 and patient diabetes history,fasting blood glucose(FPG),body mass index(BMI)and waist circumference.Serum HbA1c is linearly related to the history of diabetes and FPG.Moreover,Serum FFA level was linearly correlated with patient BMI and waist circumference.The combination of serum CA19-9,HbA1c and FFA was showed to be a valuable index,with the sensitivity of 91.5%and the specificity of 93%.Multivariate logistic regression analysis showed that high CA19-9,high HbA1c and high FFA were independent risk factors of MS,after adjusting for age,sex,smoking,drinking,diabetes,hypertension,obesity and blood fat index.Conclusion Serum CA19-9,HbA1c and FFA values have potential diagnostic values for MS,which could provide novel information for the diagnosis and treatment of MS patients.