CTRP9对冠心病合并2型糖尿病患者冠状动脉钙化的预测价值

Predictive Value of CTRP9 on Coronary Artery Calcification in Patients with Coronary Heart Disease Complicated with Type 2 Diabetes Mellitus

目的探讨C1q肿瘤坏死因子相关蛋白9(CTRP9)对2型糖尿病(T2DM)患者冠状动脉钙化(CAC)的预测价值。方法收集2021年3月—12月在河北医科大学第二医院住院的201例冠心病患者资料。根据是否存在T2DM和CAC分为四组:无糖尿病无钙化患者(对照组)32例,单纯CAC患者(CAC组)45例,单纯T2DM患者(T2DM组)50例和T2DM合并CAC患者(T2DM+CAC组)74例。采用ELISA法检测各组患者血浆CTRP9水平。采用多因素logistic回归分析评估CTRP9是否为T2DM患者CAC的独立危险因素,并通过受试者工作特征曲线评估CTRP9对T2DM患者合并CAC的预测价值。结果四组患者在年龄、吸烟史、高血压、心力衰竭、糖化血红蛋白、空腹血糖、高密度脂蛋白胆固醇、载脂蛋白A1、肌红蛋白、乳酸脱氢酶、β2微球蛋白、CTRP9方面比较,差异有统计学意义(P<0.05)。与T2DM组相比,T2DM+CAC组患者的年龄较大,男性、高血压患者占比增高,高密度脂蛋白胆固醇、CTRP9水平显著降低,差异均有统计学意义。多因素logistic回归分析显示,年龄和高血压均为糖尿病患者CAC的独立危险因素,CTRP9为CAC的保护因素。受试者工作特征曲线显示,血浆CTRP9水平预测T2DM患者CAC曲线下面积为0.747(敏感度为78.4%,特异度为78.0%)。结论CTRP9是CAC的保护因素,血浆CTRP9水平对T2DM患者发生CAC具有良好的预测价值。

Objective To explore the predictive value of CTRP9 for coronary artery calcification(CAC)in patients with type 2 diabetes mellitus(T2DM).Methods The data of 201 patients with coronary heart disease admitted to The Second Hospital of Hebei Medical University from March 2021 to December 2021 were collected.The patients were divided into 4 groups based on the presence or absence of T2DM and CAC:control group(no coronary calcification and diabetes,32 cases),CAC group(CAC without T2DM,45 cases),T2DM group(T2DM without CAC,50 cases)and T2DM+CAC group(T2DM combined with CAC,74 cases).Plasma CTRP9 levels were measured using a commercial enzyme-linked immunosorbent assay kit.Using multivariable logistic regression analysis to assess whether CTRP9 independent risk factor for CAC in patients with T2DM and the predictive value of CTRP9 in patients with T2DM complicated with CAC was evaluated by ROC curve.Results There were significant differences in age,smoking history,hypertension,heart failure,HbA1c,GLU,HDL-C,ApoA,MYO,LDH,β2MG and CTRP9 among the four groups(P<0.05).Compared with the T2DM group,the age of the T2DM+CAC group was older,the proportion of male and hypertensive patients was higher,and the levels of HDL-C and CTRP9 were significantly lower,the differences were statistically significant.Multivariate logistic regression analysis showed that age and hypertension were independent risk factors for CAC in diabetic patients,and CTRP9 was a protective factor for CAC.The ROC curve showed that the plasma CTRP9 level predicted that the area under the CAC curve in diabetic patients was 0.747(sensitivity 78.4%,specificity 78.0%).Conclusion CTRP9 is a protective factor of CAC,and the decrease of plasma CTRP9 level has a good predictive value in patients with T2DM complicated with CAC.