脂质运载蛋白2和脂蛋白相关性磷脂酶A2及血小板淋巴细胞比值水平变化与糖尿病患者心血管事件的关系探讨

To explore the relationship between lipocalin-2 and lipoprotein-associated phospholipase A2 and plateletto-lymphocyte ratio levels and cardiovascular events in diabetic patients

目的探讨脂质运载蛋白2(lipocalin-2)、脂蛋白相关性磷脂酶A2(Lp-PLA2)、血小板淋巴细胞比值(PLR)水平变化与糖尿病患者心血管事件(CVE)的关系。方法选取2018年2月至2019年2月海南省中医院108例2型糖尿病(T2DM)患者为研究组,同期54例健康体检者为参照组。比较两组血清lipocalin-2、Lp-PLA2、PLR水平及弗雷明翰心血管风险评分(Framingham评分),分析T2DM患者血清lipocalin-2、Lp-PLA2、PLR水平与Framingham评分的相关性,logistic回归分析T2DM患者CVE风险的影响因素,受试者工作特征(ROC)曲线分析血清lipocalin-2、Lp-PLA2、PLR水平对T2DM患者CVE的预测价值。结果研究组血清lipocalin-2、Lp-PLA2、PLR水平及Framingham评分高于参照组(P<0.05);T2DM患者血清lipocalin-2、Lp-PLA2、PLR水平与Framingham评分呈正相关关系(P<0.05);Logistic回归结果显示,校正年龄、T2DM病程、HbAlc、LDL-C后,Framingham评分及血清lipocalin-2、Lp-PLA2、PLR水平升高均为T2DM患者CVE发生的危险因素(P<0.05);ROC曲线显示,lipocalin-2、Lp-PLA2、PLR联合预测T2DM患者CVE的AUC值0.860最大,对应敏感度为75.00%,特异度为87.13%。结论T2DM患者血清lipocalin-2、Lp-PLA2、PLR异常高表达,且是CVE发生的独立危险因素。

Objective To explore the relationship between lipocalin-2(lipocalin-2),lipoprotein-associated phospholipase A2(Lp-PLA2),platelet-to-lymphocyte ratio(PLR)levels and cardiovascular events in diabetic patients.Methods A total of 108 patients with type 2 diabetes mellitus(T2DM)in Hainan Hospital of Traditional Chinese Medicine from February 2018 to February 2019 were selected as the study group,and 54 healthy patients were selected as the reference group during the same period.The serum lipocalin-2,Lp-PLA2,PLR levels and Framingham score were compared between the two groups.The correlation between serum lipocalin-2,Lp-PLA2,PLR levels and Framingham score in patients with T2DM were analyzed.Logistic regression was used to analyze the influencing factors of cardiovascular event risk in T2DM patients.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum lipocalin-2,Lp-PLA2,PLR levels on cardiovascular events in T2DM patients.Results Serum lipocalin-2,Lp-PLA2,PLR levels and Framingham score in the research group were higher than those in the reference group(P<0.05);Serum lipocalin-2,Lp-PLA2,PLR levels in patients with T2DM were positively correlated with Framingham score(P<0.05);Logistic regression results showed that after adjusting for age,T2DM course,HbAlc,LDL-C,Framingham score and elevated serum lipocalin-2,Lp-PLA2,PLR levels were risk factors for cardiovascular events in T2DM patients(P<0.05);The ROC curve showed that lipocalin-2,Lp-PLA2,and PLR had the highest AUC value of 0.860 in predicting cardiovascular events in patients with T2DM,the corresponding sensitivity was 75.00%,and the specificity was 87.13%.Conclusion Serum lipocalin-2,Lp-PLA2 and PLR are abnormally high in patients with T2DM,and they are independent risk factors for cardiovascular events.