超极速脉搏波技术定量参数与代谢综合征患者血清Gal-3、IL-33水平的相关性分析

Correlation analysis of quantitative parameters of ultrafast pulse wave velocity technique with serum Gal-3 and IL-33 levels in patients with metabolic syndrome

目的探究超极速脉搏波(ultra fast Pulse wave velocity,ufPWV)技术定量参数与代谢综合征患者血清半乳糖凝集素3(Galectin-3,Gal-3)、白细胞介素33(interleukin-33,IL-33)水平的相关性。方法选取代谢综合征患者150例作为观察组,分为3组,Ⅰ组:颈动脉内膜-中层厚度(intima media thickness,IMT)正常(<1.0 mm)患者50例,Ⅱ组:颈动脉IMT增厚(1.0 mm≤IMT<1.5 mm)50例,Ⅲ组:颈动脉IMT≥1.5 mm 50例。另选取同期体检健康者50例作为对照组。比较一般资料、ufPWV技术定量参数收缩起始时脉搏波传导速度(pulse wave velocity at the beginning of contraction,PWV-BS)、收缩结束时脉搏波传导速度(pulse wave velocity at the end of contraction,PWV-ES),检测Gal-3、IL-33,评价ufPWV技术定量参数及血清Gal-3、IL-33水平对代谢综合征的诊断价值,分析ufPWV技术定量参数与血清Gal-3、IL-33水平相关性及ufPWV技术定量参数及血清Gal-3、IL-33水平与颈动脉IMT相关性,分析ufPWV技术定量参数、Gal-3、IL-33对颈动脉粥样硬化斑块发病危险度的影响。结果观察组心率、体重指数、收缩压、舒张压、空腹血糖、三酰甘油、总胆固醇、高密度脂蛋白及低密度脂蛋白均高于对照组(P<0.05);观察组ufPWV技术定量参数PWV-BS、PWV-ES及血清Gal-3、IL-33水平均高于对照组(P<0.05),Ⅰ组ufPWV技术定量参数PWV-BS、PWV-ES及血清Gal-3、IL-33水平均低于Ⅱ组,且Ⅱ组各指标低于Ⅲ组(P<0.05);ufPWV技术定量参数及血清Gal-3、IL-33水平诊断代谢综合征的ROC曲线的AUC分别为0.836、0.802、0.818、0.823,联合诊断AUC为0.901,较各指标单独诊断价值明显提高;ufPWV技术定量参数PWV-BS、PWV-ES与血清Gal-3、IL-33水平均呈正相关关系(P<0.05);ufPWV技术定量参数PWV-BS、PWV-ES及血清Gal-3、IL-33水平均与颈动脉IMT呈正相关关系(P<0.05);ufPWV技术定量参数、Gal-3、IL-33高水平者颈动脉粥样硬化斑块发生危险度分别是低水平者的2.490倍、2.490倍、2.698倍、2.212倍。结论代谢综合征患者ufPWV技术定量参数PWV-BS、PWV-ES与血清Gal-3、IL-33水平呈正相关关系,且其水平与代谢综合征及动脉粥样硬化发生发展有关,可提示颈动脉斑块发生,为临床诊疗提供参考依据。

Objective To investigate the correlation between quantitative parameters of ultrafast pulse wave velocity(ufPWV)technique and serum galectin-3(Gal-3)and interleukin-33(IL-33)levels in patients with metabolic syndrome.Methods In total,150 patients with metabolic syndrome were selected as the observation group and divided into three groups:groupⅠ:50 patients with normal carotid intima-media thickness(IMT)(<1.0 mm),groupⅡ:50 patients with thickened carotid IMT(1.0 mm≤IMT<1.5 mm)and groupⅢ:50 patients with carotid IMT≥1.5 mm.Another 50 healthy physical examinees during the same period were selected as controls.The general data,quantitative parameters of ufPWV technique,including pulse wave velocity at the beginning of systole(PWV-BS),pulse wave velocity at the end of systole(PWV-ES),and the measurement of Gal-3 and IL-33 were compared.Gal-3 and IL-33 were detected,to evaluate the diagnostic value of quantitative parameters of ufPWV technique and serum Gal-3 and IL-33 levels for metabolic syndrome.In addition,the correlation between quantitative parameters of ufPWV technique and serum Gal-3 and IL-33 levels,and the correlation of quantitative parameters of ufPWV technique and serum Gal-3 and IL-33 levels with carotid IMT were analyzed.The impact of quantitative parameters of ufPWV technique,Gal-3 and IL-33 on the risk of carotid atherosclerotic plaque(CAP)was analyzed.Results Heart rate,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),triglyceride(TG),total cholesterol(TC),high-density lipoprotein(HDL-C)and low-density lipoprotein(LDL-C)were higher in the observation group than in the control group(P<0.05).The quantitative parameters of ufPWV technique,including PWV-BS and PWV-ES,and serum Gal-3 and IL-33 levels were higher in the observation group than in the control group(P<0.05).The quantitative parameters of ufPWV technique,including PWV-BS,PWV-ES,and serum Gal-3 and IL-33 levels were lower in groupⅠthan in groupⅡ,and lower in groupⅡthan in groupⅢ(P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC)of quantitative parameters of ufPWV technique and serum Gal-3 and IL-33 levels for the diagnosis of metabolic syndrome was 0.836,0.802,0.818 and 0.823,respectively,and the AUC for the combined diagnosis was 0.901,which was significantly higher than the diagnostic value of each index alone;The quantitative parameters of ufPWV technique,including PWV-BS and PWV-ES had a positive correlation with serum Gal-3 and IL-33 levels,and the quantitative parameters of ufPWV technique,PWV-BS and PWV-ES,as well as serum Gal-3 and IL-33 levels,were positively correlated with carotid IMT(P<0.05).The risk of CAP development was 2.490,2.490,2.698,and 2.212 times higher in those with high levels of the quantitative parameters of ufPWV technique,Gal-3,and IL-33,respectively,than in those with low levels.Conclusion In patients with metabolic syndrome,quantitative parameters of ufPWV technique,PWV-BS and PWV-ES,are positively correlated with serum Gal-3 and IL-33 levels,and their levels are related to the development of metabolic syndrome and atherosclerosis,which can indicate the occurrence of carotid plaque and provide a reference basis for clinical diagnosis and treatment.