血清骨桥蛋白和骨保护素与2型糖尿病合并冠心病的相关性分析

Correlation between serum osteopontin and osteopontin and type 2 diabetes mellitus with coronary heart disease

目的探讨血清骨桥蛋白、骨保护素与2型糖尿病(type 2 diabetes mellitus,T2DM)合并冠心病的关系,并评价T2DM患者血清骨桥蛋白、骨保护素水平与冠状动脉病变严重程度的相关性。方法连续入选2019年11月至2020年12月于承德医学院附属医院疑诊为稳定性冠心病,并行冠状动脉造影术检查的100例T2DM患者,依据冠状动脉造影结果将确诊为冠心病的60例患者设为病例组,40例非冠心病患者设为对照组,进行回顾性病例对照研究。记录所有患者的临床资料及生化检测指标,并计算Gensini评分,采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)法定量测定血清骨桥蛋白、骨保护素的浓度。正态分布的计量资料两组间比较采用独立样本t检验;非正态分布数据以M(Q1,Q3)表示,组间比较选用Mann-Whitney U检验;计数资料组间比较采用χ^(2)检验。通过单因素及多因素分析骨桥蛋白、骨保护素与T2DM合并冠心病的关系;Spearman相关性分析T2DM患者血清骨桥蛋白、骨保护素与Gensini评分的相关性。结果单因素分析结果显示,病例组患者血清骨桥蛋白[13.076(8.433,23.552)μg/L]、骨保护素[0.437(0.300,0.630)μg/L]均明显高于对照组[血清骨桥蛋白:6.367(4.605,9.048)μg/L,骨保护素:0.299(0.196,0.399)μg/L],组间比较差异有统计学意义(Z值分别为5.12、3.28,均P<0.001)。多因素Logistic回归分析显示,血清骨保护素(OR=2.887,95%CI:1.850~8.515,P=0.024)、骨桥蛋白(OR=13.109,95%CI:2.557~67.204,P=0.002)与T2DM合并冠心病有关,血清骨保护素、骨桥蛋白水平升高,T2DM合并冠心病的危险性增大。Spearman相关性分析显示,血清骨桥蛋白、骨保护素与Gensini评分呈正相关(r值分别为0.591、0.467,均P<0.05)。结论血清骨桥蛋白、骨保护素与T2DM合并冠心病有关,高血清骨桥蛋白、骨保护素是T2DM合并冠心病的危险因素;T2DM患者血清骨桥蛋白、骨保护素与冠状动脉病变程度呈正相关。

Objective To study the relationship between serum osteopontin and osteopontin and type 2 diabetes mellitus(T2DM)complicated with coronary heart disease,and to evaluate the correlation between the levels of serum osteopontin and osteopontin with the severity of coronary artery lesions in T2DM patients.Methods A total of 100 T2DM patients who were suspected to have stable coronary heart disease and underwent coronary angiography from November 2019 to December 2020 were selected from the Affiliated Hospital of Chengde Medical College,according to coronary angiography results,60 patients with confirmed coronary heart disease were classified as the case group and 40 patients with non-coronary heart disease were classified as the control group for retrospective analysis.The clinical data and biochemical indicators of all patients were recorded,and Gensini score was calculated.The concentration of osteopontin and osteopontin in serum was quantitatively determined by double-antibody enzyme linked immunosorbent assay method.Independent sample t-test was used to compare the mean of normal distribution measurement data between the two groups.The non normal distribution data are represented by M(Q1,Q3),and Mann Whitney U test is used for comparison between groups.Composition comparison between count data groupsχ^(2) inspection.Spearman correlation analysis was used to analyze the correlation between serum osteopontin and osteopontin and Gensini score in patients with T2DM.Results Univariate analysis showed that serum osteopontin and osteopontin were(13.076(8.433,23.552)μg/L)and(0.437(0.300,0.630)μg/L)significantly higher in the case group than in the control group(6.367(4.605,9.048)μg/L)and(0.299(0.196,0.399)μg/L)respectively,with statistically significant differences(Z=5.12,3.28,all P<0.001).Multi-factor logistic regression analysis showed that osteoprotegerin(OR=2.887,95%CI:1.850-8.515,P=0.024)and osteopontin(OR=13.109,95%CI:2.557-67.204,P=0.002)were associated with T2DM combined with coronary heart disease,and the risk of T2DM combined with coronary heart disease increased with higher levels of osteoprotegerin and osteopontin.Spearman correlation analysis showed that serum osteopontin and osteoprotegerin were positively correlated with Gensini score in T2DM patients(r=0.591,0.467;all P<0.05).Conclusion Serum osteopontin and osteoprotegerin are associated with T2DM combined with coronary heart disease,and high serum osteopontin and osteoprotegerin are risk factors for T2DM combined with coronary heart disease;serum osteopontin and osteoprotegerin are positively correlated with the degree of coronary artery disease in T2DM patients.