2型糖尿病患者血清SAA、25(OH)D3表达变化及其与血脂代谢和炎症因子的关联性

Changes of serum SAA and 25(OH)D3 expression in patients with type 2 diabetes mellitus and their association with lipid metabolism and inflammatory factors

目的分析2型糖尿病患者血清淀粉样蛋白A(SAA)、25-羟维生素-D3[25(OH)D3]表达变化及其与血脂代谢和炎症因子指标的关联性。方法回顾性选取2018年3月至2021年2月丹东市第一医院收治的98例2型糖尿病患者作为研究对象(研究组),同时选取98例同期健康体检者为对照(对照组),检测两组研究对象的血清SAA、25(OH)D3、血脂代谢指标[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)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)]、炎症因子指标[白细胞介素(IL)-1、IL-6、肿瘤坏死因子-α(TNF-α)]水平。2型糖尿病患者血清SAA、25(OH)D3表达与TC、TG、HDL-C、LDL-C、ApoA1/ApoB、IL-1、IL-6、TNF-α的关联性采用Pearson相关分析。结果研究组血清SAA、25(OH)D3、TC、TG、HDL-C、LDL-C、ApoA1/ApoB、IL-1、IL-6、TNF-α水平分别为(564.85±102.54)μg/L、(35.71±5.42)nmol/L、(5.82±1.50)mmol/L、(2.91±0.57)mmol/L、(1.17±0.16)mmol/L、(3.71±0.53)mmol/L、1.68±0.26、(166.15±19.31)pg/mL、(169.56±22.36)pg/mL、(25.47±3.83)pg/mL,对照组血清SAA、25(OH)D3、TC、TG、HDL-C、LDL-C、ApoA1/ApoB、IL-1、IL-6、TNF-α水平分别为(496.27±94.43)μg/L、(50.68±6.43)nmol/L、(4.67±1.28)mmol/L、(1.48±0.48)mmol/L、(1.51±0.20)mmol/L、(2.16±0.42)mmol/L、2.17±0.35、(129.72±20.04)pg/mL、(89.56±10.84)pg/mL、(10.40±1.56)pg/mL,两组相比差异有统计学意义(P<0.001)。Pearson相关分析显示,2型糖尿病患者血清SAA表达与TC、TG、LDL-C、IL-1、IL-6和TNF-α呈正相关(r=0.439、0.493、0.501、0.437、0.443、0.495,P<0.001),与HDL-C和ApoA1/ApoB呈负相关(r=-0.445、-0.461,P<0.001);血清25(OH)D3表达与HDL-C和ApoA1/ApoB呈正相关(r=0.702、0.597,P<0.001),与TC、TG、LDL-C、IL-1、IL-6和TNF-α呈负相关(r=-0.437、-0.699、-0.459、-0.613、-0.655、-0.478,P<0.001)。结论2型糖尿病患者血清SAA高表达、25(OH)D3低表达与其血脂代谢紊乱及炎症因子异常分泌有较强关联性,可作为患者病情监测评估的参考指标。

Objective To analyze the changes of serum amyloid A(SAA)and 25-hydroxyvitamin-D3[25(OH)D3]expression in patients with type 2 diabetes mellitus and their correlation with lipid metabolism and inflammatory cytokines.Methods A total of 98 patients with type 2 diabetes who were admitted to Dandong First Hospital from March 2018 to February 2021 were selected as the research objects(research group),and 98 healthy subjects were retrospectively selected as the control group(control group).Detect serum SAA,25(OH)D3,blood lipid metabolism indexes[total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB)],inflammatory factor indicators[interleukin(IL)-1,IL-6,tumor necrosis factor-α(TNF-α)]levels.The correlation between serum SAA,25(OH)D3 expression and TC,TG,HDL-C,LDL-C,ApoA1/ApoB,IL-1,IL-6,and TNF-αin patients with type 2 diabetes was analyzed by Pearson correlation analysis.Results The serum levels of SAA,25(OH)D3,TC,TG,HDL-C,LDL-C,ApoA1/ApoB,IL-1,IL-6 and TNF-αin the study group were(564.85±102.54)g/L,(35.71±5.42)nmol/L,(5.82±1.50)mmol/L,(2.91±0.57)mmol/L,(1.17±0.16)mmol/L,(3.71±0.53)mmol/L,1.68±0.26,(166.15±19.31)pg/mL,(169.56±22.36)pg/mL,(25.47±3.83)pg/mL;the serum levels of SAA,25(OH)D3,TC,TG,HDL-C,LDL-C,ApoA1/ApoB,IL-1,IL-6 and TNF-αin control group were(496.27±94.43)g/L,(50.68±6.43)nmol/L,(4.67±1.28)mmol/L,(1.48±0.48)mmol/L,(1.51±0.20)mmol/L,(2.16±0.42)mmol/L,2.17±0.35,(129.72±20.04)pg/mL,(89.56±10.84)pg/mL,(10.40±1.56)pg/mL,the difference was statistically significant(P<0.001);Pearson correlation analysis showed that serum SAA expression in patients with type 2 diabetes was positively correlated with TC,TG,LDL-C,IL-1,IL-6 and TNF-α(r=0.439,0.493,0.501,0.437,0.443,0.495,P<0.001);they were negatively correlated with HDL-C and ApoA1/ApoB(r=-0.445,-0.461,P<0.001);Serum 25(OH)D3 expression was positively correlated with HDL-C and ApoA1/ApoB(r=0.702,0.597,P<0.001).It was negatively correlated with TC,TG,LDL-C,IL-1,IL-6 and TNF-α(r=-0.437,-0.699,-0.459,-0.613,-0.655,-0.478,P<0.001).Conclusion The high expression of SAA and the low expression of 25(OH)D3 in the serum of type 2 diabetic patients are strongly correlated with the dyslipidemia and abnormal secretion of inflammatory factors,which can be used as a reference index for the monitoring and evaluation of patients'disease conditions.