血清CTRP1、FGF21和ANGPTL3水平在2型糖尿病大血管病变中的诊断价值

Diagnostic value of serum CTRP1,FGF21,and ANGPTL3 levels in macrovascular disease in type 2 diabetes

目的观察血清C1q肿瘤坏死因子相关蛋白1(CTRP1)、成纤维细胞生长因子21(FGF21)和人血管生成素样蛋白3(ANGPTL3)水平在2型糖尿病大血管病变中的诊断价值。方法选取2020年1月至2022年6月在该院诊治的165例2型糖尿病患者作为2型糖尿病组,根据患者是否合并大血管病变分为大血管病变组(57例)和单纯糖尿病组(108例),另选取同期该院75例健康体检者作为健康对照组。采用单因素和多因素分析2型糖尿病发生大血管病变的影响因素,以及血清CTRP1、FGF21和ANGPTL3水平在2型糖尿病发生大血管病变中的诊断价值。结果2型糖尿病组血清CTRP1、FGF21和ANGPTL3水平均明显高于健康对照组,差异均有统计学意义(P<0.05),并且随着糖尿病控制程度升高而降低。大血管病变组餐后2 h血糖(2 h PG)、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、颈动脉内膜中层厚度(IMT)、CTRP1、FGF21和ANGPTL3水平均明显高于单纯糖尿病组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,2 h PG、TG、颈动脉IMT、CTRP1、FGF21和ANGPTL3水平升高是发生大血管病变的独立危险因素(P<0.05)。血清CTRP1、FGF21和ANGPTL3水平在2型糖尿病发生大血管病变中具有较高的诊断效能,3项指标联合检测的灵敏度为68.4%,特异度为97.2%,受试者工作特征曲线下面积为0.897,明显高于CTRP1(Z=3.152,P=0.002)、FGF21(Z=3.755,P<0.001)和ANGPTL3(Z=4.410,P<0.001)单项检测。结论血清CTRP1、FGF21和ANGPTL3是2型糖尿病的重要监测指标,其水平升高是发生大血管病变的独立危险因素,3项指标联合检测有助于提高对2型糖尿病大血管病变的诊断效能。

Objective To investigate the diagnostic value of serum C1q tumor necrosis factor-related protein 1(CTRP1),fibroblast growth factor 21(FGF21)and human angiopoietin-like protein 3(ANGPTL3)levels in macrovascular disease in type 2 diabetes.Methods A total of 165 patients with type 2 diabetes diagnosed and treated in the hospital from January 2020 to June 2022 were selected as type 2 diabetes group.According to whether the patients were complicated with macrovascular disease,they were divided into macrovascular disease group(57 cases)and simple diabetes group(108 cases),and 75 healthy subjects in the hospital during the same period were selected as healthy control group.Univariate and multivariate analysis were used to analyze the influencing factors of macroangiopathy in type 2 diabetes,and the diagnostic value of serum CTRP1,FGF21 and ANGPTL3 levels in macrovascular disease in type 2 diabetes.Results Serum CTRP1,FGF21 and ANGPTL3 levels in type 2 diabetes group were significantly higher than those in healthy control group(P<0.05),and decreased with the increase of diabetes control degree.The levels of 2-hour postprandial blood glucose(2 h PG),triglyceride,low-density lipoprotein cholesterol(LDL-C),carotid intima-media thickness(IMT),CTRP1,FGF21 and ANGPTL3 in the macrovascular disease group were significantly higher than those in the simple diabetes group(P<0.05).Multivariate Logistic regression analysis showed that increased levels of 2 h PG,TG,carotid IMT,CTRP1,FGF21 and ANGPTL3 were independent risk factors for macrovascular disease(P<0.05).Serum CTRP1,FGF21 and ANGPTL3 levels had high diagnostic efficacy in macrovascular disease in type 2 diabetes.The sensitivity of combined detection of the 3 indicators was 68.4%,the specificity was 97.2%,and the area under the receiver operating characteristic curve was 0.897,which were significantly higher than those of single detection CTRP1(Z=3.152,P=0.002),FGF21(Z=3.755,P<0.001)and ANGPTL3(Z=4.410,P<0.001).Conclusion Serum CTRP1,FGF21 and ANGPTL3 are important monitoring indicators of type 2 diabetes,and their elevated levels are independent risk factors for macroangiopathy.Combined detection of the 3 indicators can help to improve the diagnostic effect in macrovascular disease in type 2 diabetes.