2型糖尿病患者颈动脉内膜中层厚度与血清无翅型MMTV整合位点家族成员5a及相关因素的关系

Analysis of carotid intima media thickness with serum wingless-type MMTV integration site family member 5a level and correlative factors in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者颈动脉内膜中层厚度(CIMT)与血清无翅型MMTV整合位点家族成员5a(Wnt5a)及相关因素的关系。方法选取2020年9月至2021年12月于河南省人民医院内分泌科住院的T2DM患者为研究对象。检测其血清Wnt5a、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及转化生长因子(TGF)-β1水平,测定其CIMT。依据CIMT将患者分为无增厚组(CIMT<1.0 mm)、增厚组(1.0 mm≤CIMT<1.5 mm)和斑块组(CIMT≥1.5 mm)3组。采用单因素方差分析、Kruskal-Wallis H检验或χ2检验对患者的一般临床资料进行组间比较;采用Spearman相关分析法对CIMT与Wnt5a、IL-6、TNF-α、TGF-β1,以及血清Wnt5a与IL-6、TNF-α、TGF-β1的相关性进行分析;采用多重线性回归分析法分析患者CIMT、血清Wnt5a的影响因素。结果共纳入163例患者。其中,无增厚组60例,增厚组48例,斑块组55例。与无增厚组和增厚组相比,斑块组的CIMT、Wnt5a、IL-6、TNF-α、TGF-β1均更高(均P<0.001)。相关性分析结果显示,CTMI与Wnt5a(r=0.717)、IL-6(r=0.544)、TNF-α(r=0.524)、TGF-β1(r=0.803)均呈正相关(均P<0.001),血清Wnt5a与IL-6(r=0.465)、TNF-α(r=0.453)、TGF-β1(r=0.631)均呈正相关(均P<0.001)。多重线性回归分析结果显示,Wnt5a、IL-6、TGF-β1均是CIMT的影响因素(均P<0.05),IL-6、TGF-β1均是血清Wnt5a的影响因素(均P<0.05)。结论T2DM患者的CIMT与Wnt5a及IL-6、TGF-β1等密切相关。

Objective To investigate the relationship between carotid intima media thickness(CIMT)and serum wingless-type MMTV integration site family member 5a(Wnt5a)and related factors in patients with type 2 diabetes mellitus(T2DM).Methods Patients with T2DM hospitalized in the Department of Endocrinology of Henan Provincial People′s Hospital from September 2020 to December 2021 were selected as participants.The levels of serum Wnt5a,interleukin-6(IL-6),tumor necrosis-α(TNF-α)and transforming growth factor(TGF)-β1 were detected,and the CIMT was measured.According to CIMT,the patients were divided into three groups:without thickened group(CIMT<1.0 mm),thickened group(1.0 mm≤CIMT<1.5 mm)and plaque group(CIMT≥1.5 mm).One-way analysis of variance(ANOVA),Kruskal-Wallis H test orχ2 test were used to compare the general clinical data of patients in the three groups.Spearman correlation analysis was used to analyze the correlation between CIMT and Wnt5a,IL-6,TNF-α,TGF-β1,and serum Wnt5a with IL-6,TNF-α,TGF-β1.The influencing factors of CIMT,serum Wnt5a were analyzed by multiple linear regression analysis.Results A total of 163 patients were included.There were 60 cases in without thickened group,48 cases in thickened group and 55 cases in plaque group.The levels of CIMT,Wnt5a,IL-6,TNF-αand TGF-β1 in plaque group were higher than those in without thickened group and thickened group(all P<0.001).Correlation analysis showed that CIMT was positively correlated with Wnt5a(r=0.717),IL-6(r=0.544),TNF-α(r=0.524)and TGF-β1(r=0.803)(all P<0.001).Serum Wnt5a was positively correlated with IL-6(r=0.465),TNF-α(r=0.453)and TGF-β1(r=0.631)(all P<0.001).Multiple linear regression analysis showed that Wnt5a,IL-6 and TGF-β1 were influencing factors of CIMT(all P<0.05),while IL-6 and TGF-β1 were influencing factors of serum Wnt5a(all P<0.05).Conclusion CIMT in T2DM patients was closely related to Wnt5a,IL-6 and TGF-β1.