血清抑瘤素M、腱糖蛋白-C水平与2型糖尿病合并急性冠脉综合征的关系研究

Study on the relationship between serum oncostatin M,tenascin-C levels and type 2 diabetes mellitus with acute coronary syndrome

目的探讨血清抑瘤素M(OSM)、腱糖蛋白-C(TN-C)水平与2型糖尿病(T2DM)合并急性冠脉综合征(ACS)的关系。方法选取该院2018年6月至2020年6月收治的80例T2DM合并ACS患者作为合并组,纳入同期收治的单纯T2DM、ACS患者各60例作为T2DM组、ACS组。比较3组血清OSM、TN-C水平及空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)水平,分析T2DM合并ACS患者血清OSM、TN-C水平与其他检测指标的相关性,经Logistic多元回归模型分析T2DM患者发生ACS的危险因素。结果合并组血清OSM、TN-C水平及TC、LDL-C、CK、CK-MB、cTnI高于T2DM组、ACS组,合并组FPG、HbA1c、FINS、HOMA-IR、Gensini积分高于ACS组,差异有统计学意义(P<0.05)。合并组血清OSM、TN-C水平与TC、LDL-C、CK、CK-MB、cTnI、Gensini积分呈正相关(P<0.05)。Logistic多因素回归分析显示,高血压病史、TC≥3.55 mmol/L、LDL-C≥2.21 mmol/L、CK≥179.88 U/L、CK-MB≥47.12 U/L、cTnI≥1.25μg/L、OSM≥26.52 pg/mL、TN-C≥10.92 ng/mL是T2DM患者发生ACS的危险因素(P<0.05)。结论T2DM合并ACS患者的血清OSM、TN-C水平明显升高,二者是T2DM发生ACS的独立危险因素,OSM、TN-C可作为评估T2DM合并ACS病情进展的辅助指标。

Objective To explore the relationship between serum oncostatin M(OSM),tenascin-C(TN-C)levels and Type 2 diabetes mellitus(T2DM)with acute coronary syndrome(ACS).Methods 80 patients with T2DM with ACS in our hospital from June 2018 to June 2020 were selected as the combined group,and included 60 patients with simple T2DM and ACS who were admitted in the same period as the T2DM group and ACS group.The three groups of serum OSM,TN-C levels and fasting plasma glucose(FPG),glycosylated hemoglobin A1c(HbA1c),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting insulin(FINS),homeostasis model assessment-insulin resistance index(HOMA-IR),creatine kinase(CK),creatine kinase-MB(CK-MB),cardiac troponin I(cTnI)levels were compared.The correlation between serum OSM and TN-C levels of T2DM with ACS patients with other indicators were analyzed,and the risk factors of ACS in T2DM patients were analyzed by Logistic multiple regression model.Results Serum OSM,TN-C levels and TC,LDL-C,CK,CK-MB,cTnI in the combined group were higher than those in the T2DM group and ACS group,and the FPG,HbA1c,FINS,HOMA-IR,Gensini scores in combined group were higher than those in the ACS group,the difference was statistically significant(P<0.05).Serum OSM and TN-C levels in the combined group were positively correlated with TC,LDL-C,CK,CK-MB,cTnI and Gensini scores(P<0.05).Logistic multivariate regression analysis showed that hypertension history,TC≥3.55 mmol/L,LDL-C≥2.21 mmol/L,CK≥179.88 U/L,CK-MB≥47.12 U/L,cTnI≥1.25 mmol/L,OSM≥26.52 pg/mL,TN-C≥10.92 ng/mL were risk factor for ACS in T2DM patients(P<0.05).Conclusion The levels of OSM and TN-C in T2DM patients with ACS were significantly increased.Both are independent risk factors for ACS in T2DM.OSM and TN-C can be used as auxiliary indicators to evaluate the progress of T2DM patients with ACS.