2型糖尿病患者血清脂肪细胞型脂肪酸结合蛋白、白细胞介素-17水平及其与下肢动脉粥样硬化病变的关系

Serum adipocyte-type fatty acid binding protein and interleukin-17 levels in patients with type 2 diabetes mellitus and their relationship with lower limb atherosclerosis

目的探讨2型糖尿病患者血清脂肪细胞型脂肪酸结合蛋白(A-FABP)、白细胞介素-17(IL-17)表达水平及其与下肢动脉粥样硬化病变(LEAD)的关系。方法按照踝肱指数(ABI)将2017年2～11月辽宁省金秋医院(以下简称"我院")收治的131例2型糖尿病患者分为非LEAD组(n=34)和无LEAD组(n=97),并于同期随机选取我院45名健康体检者为对照组。采用酶联免疫吸附法测定血清A-FABP、IL-17水平,Logistic回归分析2型糖尿病患者LEAD的影响因素,受试者工作特征曲线(ROC曲线)评估A-FABP、IL-17对LEAD的预测价值。结果LEAD组患者糖尿病病程长于非LEAD组(P <0.05),LEAD组、非LEAD组患者收缩压、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、低密度脂蛋白胆固醇(LDL-C)、血肌酐(SCr)、A-FABP、IL1-17水平均高于对照组,且LEAD组高于非LEAD组(P <0.05)。多因素Logistic回归分析结果显示,LDL-C、A-FABP、IL-17是2型糖尿病患者LEAD发生的独立危险因素(OR=1.418、1.657、1.619,P <0.05)。A-FABP联合IL-17的曲线下面积(AUC)为0.906,灵敏度、特异度分别为0.89、0.86,准确性为0.90。结论血清A-FABP、IL-17是2型糖尿病患者LEAD独立危险因素,早期联合检测有助于临床早期预测LEAD,从而指导临床制定早期干预措施。

Objective To investigate the relationship between serum adipocyte-type fatty acid binding protein (A-FABP) and interleukin-17 (IL-17) expression levels and lower limb atherosclerosis (LEAD) in patients with type 2 diabetes. Methods A total of 131 patients with type 2 diabetes admitted to Jinqiu Hospital of Liaoning Province (hereinafter referred to as "our hospital") from February 2017 to November 2017 were divided into non-lead group (n = 34) and non-lead group (n = 97) according to ankle-brakle index (ABI), and 45 healthy subjects in our hospital were randomly selected as the control group during the same period. Serum levels of A-FABP and IL-17 were determined by enzyme-linked immunosorbent assay, and the influencing factors of LEAD in type 2 diabetes were analyzed by Logistic regression. ROC curve was used to evaluate the predictive value of A-FABP and IL-17 on LEAD. Results The duration of diabetes in the LEAD group was longer than that in the non-lead group (P < 0.05). The systolic blood pressure, glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), low-density lipoprotein cholesterol (LDL-C), serum creatinine (SCr), A-FABP, and IL-17 levels in the LEAD group and the non-lead group were higher than those in the control group (P < 0.05). Multivariate Logistic regression analysis showed that LDL-C, A-FABP and IL-17 were independent risk factors of LEAD in type 2 diabetes (OR = 1.418, 1.657, 1.619, P < 0.05). The area under the curve (AUC) of A-FABP combined with IL-17 was 0.906, the sensitivity and specificity were 0.89 and 0.86, respectively, and the accuracy was 0.90. Conclusion Serum A-FABP and IL-17 are independent risk factors of LEAD in patients with type 2 diabetes. Early combined detection is helpful to predict LEAD in the early clinical stage, so as to guide clinical development of early intervention measures.