血清Apelin、HIF-1α水平与2型糖尿病合并下肢血管病变的关系

The relationship between serum Apelin,HIF-1αlevels and type 2 diabetes mellitus complicated with lower extremity arterial disease

目的:探讨爱帕琳肽(Apelin)、缺氧诱导因子-1α(HIF-1α)与2型糖尿病(T2DM)合并下肢血管病变(LEAD)的关系。方法:选取2019年3月至2022年6月本院收治的110例T2DM患者为研究对象,根据是否合并LEAD将患者分为合并LEAD组(n=55)和未合并LEAD组(n=55),同期选择50例健康体检志愿者为对照组。收集一般资料,采用酶联免疫吸附法检测3组研究对象血清中Apelin、HIF-1α表达水平;Pearson法分析Apelin、HIF-1α与临床相关指标的相关性;受试者工作特征(ROC)曲线分析Apelin、HIF-1α水平对T2DM合并LEAD的诊断价值;采用Logistic回归分析影响LEAD的因素。结果:与对照组相比,合并LEAD组和未合并LEAD组患者血清中Apelin、HIF-1α水平均升高,且合并LEAD组高于未合并LEAD组患者,差异有统计学意义(P<0.05)。T2DM合并LEAD患者血清中Apelin与HIF-1α表达呈正相关(r=0.457,P<0.05)。Pearson法分析结果显示,T2DM合并LEAD患者血清中Apelin表达与TC、TG、LDL-C、FPG、HbA1c、FINS表达呈正相关,与HDL-C表达呈负相关(均P<0.05);血清中HIF-1α表达与TC、TG、FPG、HbA1c、FINS表达呈正相关,与HDL-C表达呈负相关(均P<0.05)。ROC曲线结果显示,血清Apelin、HIF-1α水平预测T2DM合并LEAD的AUC分别为0.884、0.900,对应的敏感度分别为72.73%、90.91%,特异度分别为94.55%、80.00%;血清Apelin、HIF-1α水平联合预测的AUC为0.954,敏感度为92.73%,特异度为89.09%。Logistic回归分析结果显示,Apelin、HIF-1α、HbA1c、LDL-C均与T2DM患者合并LEAD的发生有关(P<0.05)。结论:Apelin、HIF-1α在T2DM合并LEAD患者血清中均呈高表达,二者可作为诊断T2DM合并LEAD患者的血清标志物。

Objective:To investigate the relationship between Apelin,hypoxia-inducible factor-1α(HIF-1α)and type 2 diabetes mellitus(T2DM)complicated with lower extremity arterial disease(LEAD).Methods:A total of 110 patients with T2DM who were admitted to our hospital from March 2019 to June 2022 were regarded as the research objects,and the patients were devided into two groups according to whether they were combined with LEAD:complicated with LEAD group(n=55)and uncomplicated with LEAD group(n=55),meantime,50 healthy volunteers were regarded as the control group.General informations were collected,the expression levels of Apelin and HIF-1αin serum were detected by enzyme-linked immunosorbent assay;Pearson method was applied to analyze the correlation between Apelin,HIF-1αand clinically relevant indexes;receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of Apelin and HIF-1αlevels for T2DM complicated with LEAD;Logistic regression was applied to analyze factors affecting LEAD.Results:Compared with the control group,the levels of Apelin and HIF-1αin the serum of patients with LEAD and without LEAD were increased,and which in the complicated with LEAD group were higher than those in the uncomplicated with LEAD group(P<0.05).The expression of Apelin in serum of T2DM patients with LEAD was positively correlated with HIF-1α(r=0.457,P<0.05).The results of Pearson analysis showed that the expression of Apelin in serum of T2DM patients with LEAD was positively correlated with the expression of TC,TG,LDL-C,FPG,HbA1c and FINS,and negatively correlated with the expression of HDL-C(all P<0.05);the expression of HIF-1αin serum was positively correlated with the expression of TC,TG,FPG,HbA1c and FINS,and negatively correlated with the expression of HDL-C(all P<0.05).The ROC curve results showed that the AUC of serum Apelin and HIF-1αlevels in predicting T2DM complicated with LEAD was 0.884 and 0.900,respectively,the corresponding sensitivity was 72.73%and 90.91%,respectively,and the specificity was 94.55%and 80.00%,respectively;the AUC of the combined prediction of serum Apelin and HIF-1αlevels was 0.954,the sensitivity was 92.73%,and the specificity was 89.09%.Logistic regression analysis showed that Apelin,HIF-1α,HbA1c and LDL-C were associated with the occurrence of LEAD in T2DM patients(P<0.05).Conclusion:Apelin and HIF-1αare highly expressed in the serum of patients with T2DM complicated with LEAD,and they can be used as the serum markers for the diagnosis of patients with T2DM complicated with LEAD.