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白蛋白球蛋白比值与老年糖尿病患者下肢动脉疾病的关系 被引量:7

Relationship between albumin to globulin ratio and lower extremity arterial disease in elderly DM patients
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摘要 目的探讨老年糖尿病患者白蛋白球蛋白比值(AGR)与下肢动脉疾病(LEAD)的关系。方法收集2019年1月21日~2021年8月4日南方医科大学南方医院内分泌科行踝肱指数(ABI)检测的老年糖尿病患者266例,根据诊断分为LEAD组81例,非LEAD组185例。又根据ABI水平分为低ABI组81例(ABI≤0.9),中ABI组30例(0.9<ABI≤1.0),高ABI组155例(1.0<ABI)。收集一般临床资料及实验室检查结果。绘制ROC曲线评估C反应蛋白(CRP)和CRP/AGR对LEAD的预测价值。采用多因素二元logistic回归分析LEAD的危险因素。结果与非LEAD组比较,LEAD组年龄、冠状动脉病变、高血压、吸烟、CRP、CRP/AGR、肌酐水平明显升高,HDL-C、白蛋白、AGR明显降低(P<0.05,P<0.01)。低ABI组AGR明显低于中ABI组和高ABI组(P<0.01)。多因素logistic回归分析显示,校正冠状动脉病变、高血压、病程、肌酐、白蛋白、HDL-C后,吸烟、年龄、CRP、AGR与LEAD独立相关(P<0.01)。ROC曲线分析显示,CRP、CRP/AGR预测LEAD的曲线下面积分别为0.732(95%CI:0.663~0.802)、0.741(95%CI:0.673~0.809),CRP/AGR最佳截断值为6.313,敏感性、特异性分别为60.5%,83.8%。结论低AGR与老年糖尿病患者LEAD发生相关,可能是老年糖尿病患者发生LEAD新的危险因素。 Objective To study the relationship between albumin to globulin ratio(AGR)and lower extremity arterial disease(LEAD)in elderly DM patients.Methods Two hundred and sixtysix elderly DM patients who underwent ankle-brachial index(ABI)detection in our hospital from 2019-01-21 to 2021-08-04 were divided into LEAD group(n=81)and LEAD-free group(n=185)according to their ABI.The patients were further divided into low ABI group(n=81),medium ABI group(n=30)and high ABI group(n=155).Their general clinical data and laboratory testing parameters were recorded.The value of CRP and CRP/AGR for predicting LEAD in elderly DM patients was assessed by ROC curve analysis.The risk factors for LEAD in elderly DM patients were analyzed by binary logistic regression analysis.Results The age was significantly older,the incidence of coronary artery disease and hypertension,the serum levels of CRP and creatinine,and the CRP/AGR were significantly higher,the history of smoking was significantly longer while the serum HDL-C,albumin levels and the AGR were significantly lower in LEAD group than in LEAD-free group(P<0.05,P<0.01).The AGR was significantly lower in low ABI group than in medium and high ABI groups(P<0.01).Multivariate logistic regression analysis showed that smoking,age,CRP and AGR were independent risk factors for LEAD in elderly DM patients after adjustment of coronary artery disease,hypertension,course of DM,serum levels of creatinine,albumin and HDL-C(P<0.01).ROC curve analysis displayed that the AUC of CRP for predicting LEAD in elderly DM patients was 0.732(95%CI:0.663-0.802),while that of CRP/AGR for predicting LEAD in elderly DM patients was 0.741(95%CI:0.673-0.809)with an optimal cut-off value of 6.313,a sensitivity of 60.5%and a specificity of 83.8%.Conclusion Lower AGR is closely related with LEAD and is a new risk factor for LEAD in elder-ly DM patients.
作者 姚辉 马煜盛 吕萍 薛雅芝 蔡文怡 黄雪敏 杨翠绮 郭志刚 Yao Hui;Ma Yusheng;LüPing;Xue Yazhi;Cai Wenyi;Huang Xuemin;Yang Cuiqi;Guo Zhigang(Huiqiao Medical Center,Southern Medical University Nanfang Hospital,Guangzhou 510515,Guangdong Province,China)
出处 《中华老年心脑血管病杂志》 北大核心 2022年第3期233-236,共4页 Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金 广东省教育厅高水平大学建设经费南方医科大学临床研究启动计划项目(LC2016PY002) 南方医科大学南方医院临床研究专项(2018CR051)。
关键词 糖尿病 动脉粥样硬化 外周动脉疾病 白蛋白类 吸烟 diabetes mellitus atherosclerosis peripheral arterial disease albumins smoking
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