2型糖尿病合并微血管病变患者血清骨桥蛋白水平的变化及临床意义

Changes and Clinical Significance of Serum Osteopontin Levels in Type 2 Diabetic Patients with Microangiopathy

目的:分析2型糖尿病(T2DM)合并微血管病变患者血清骨桥蛋白(OPN)水平的变化及临床意义。方法:选取T2DM患者265例,根据是否合并微血管病变分为单纯T2DM组(A组)152例和微血管病变组(B组)113例,选取来我院体检的健康志愿者为对照组(N组)80例,比较三组间OPN差异。同时比较T2DM患者无糖尿病肾病组(NDN组)、糖尿病肾病组(DN组)血清OPN水平差异,比较T2DM患者无糖尿病视网膜病变组(NDR组)、DR非增殖期组(NPDR组)、DR增殖期组(PDR组)的血清OPN水平差异。结果:B组OPN水平明显高于A组、N组,差异均有统计学意义(P<0.05)。DN组OPN水平高于NDN组,NPDR组OPN水平高于NDR组,PDR组OPN水平高于NPDR组,差异均有统计学意义(P<0.05)。二元Logstic回归分析显示,OPN是T2DM患者合并微血管病变的独立危险因素。ROC曲线评价血清OPN水平对2型糖尿病合并微血管病变的诊断价值,为中度预测性能(AUC为0.787)。结论:血清OPN水平与T2DM患者微血管病变的发生及严重程度相关。

Objective: To analyze the change of osteopontin (OPN) in type 2 diabetic (T2DM) patients with microangiopathy. Methods: 265 patients with type 2 diabetes mellitus (T2DM) were divided into simple type 2 diabetes mellitus (group A) 152 cases and microangiopathy group (group B) 113 cases. Eighty healthy volunteers who came to our hospital for physical examination were selected as control group (group N). The differences of OPN among the three groups were compared. The difference of serum OPN level between non-diabetic nephropathy group (NDN group) and diabetic nephropathy group (DN group) was compared. The difference of serum OPN level between non-diabetic retinopathy group (NDR group),non-proliferative phase group (NPDR group) and proliferative phase group (PDR group) was compared. Results: The level of OPN in group B was significantly higher than that in group A and group N (P < 0.05). The level of OPN in DN group was higher than that in NDN group,NPDR group was higher than that in NDR group,and PDR group was higher than that in NPDR group,with statistical significance (P < 0.05). Bivariate Logstic regression analysis showed that OPN was an independent risk factor for microangiopathy in patients with T2DM. ROC curve was used to evaluate the diagnostic value of serum OPN level in type 2 diabetes mellitus with microangiopathy,which was moderately predictive (AUC 0.787). Conclusion: Serum OPN level is correlated with the occurrence and severity of microangiopathy in patients with T2DM.