2型糖尿病155例血清肌腱蛋白C水平与颈动脉粥样硬化的相关性分析

Analysis of correlation between serum tenascin-c and carotid atherosclerosis in 155 patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)病人血清肌腱蛋白C(TNC)水平与颈动脉粥样硬化(CAS)的相关性。方法横断面研究,共纳入2021年3月至2021年9月在苏州大学附属第一医院住院的155例T2DM病人。收集其临床资料,采用酶联免疫吸附法检测血清TNC水平。根据超声测定颈动脉内膜中层厚度(CIMT)将病人分为正常组(35例)、内膜增厚组(48例)和斑块形成组(72例)。采用单因素及多因素分析法,对T2DM病人CIMT增厚的独立影响因素进行分析;采用Spearman相关性分析血清TNC与其他临床参数相关性;受试者操作特征(ROC)曲线分析T2DM人群中血清TNC对CAS的诊断价值。结果对病人血清TNC水平比较,斑块形成组137.20(119.11,150.36)ng/L高于内膜增厚组121.64(101.18,141.75)ng/L和正常组110.63(84.59,125.38)ng/L,内膜增厚组高于正常组(P<0.001)。CIMT随着血清TNC升高而增加(趋势P<0.001)。logistic回归分析结果显示,血清TNC是T2DM病人CIMT增厚的独立危险因素。Spearman相关分析显示,T2DM病人血清TNC水平和身体质量指数、腰围呈正相关;ROC曲线分析显示,TNC是预测CAS发生的良好指标。当TNC取最佳截断值125.38 ng/L,灵敏度为77%,特异度为59%。结论血清TNC水平升高是T2DM病人CIMT增厚的独立危险因素,可成为预测T2DM病人CAS风险的潜在血清学指标。

Objective To observe the relationship between serum tenascin-c(TNC)level and the risk of carotid atherosclerosis(CAS)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 155 T2DM patients who were admitted to the First Affiliated Hospital of Soochow University from March 2021 to September 2021 were included in this cross-sectional study.Basic and clinical information for these research objects were analyzed.Serum TNC level was assessed by enzyme linked immunosorbent assay(ELISA).Based on their carotid intima-media thickness(CIMT)detected by carotid ultrasonography,participants were assigned into the normal group(n=35),CIMT thickening group(n=48)and carotid atherosclerosis plaque formation group(n=72).Univariate and multivariate analysis were used to determine independent risk factors for the elevated CIMT in patients with T2DM.Correlations between serum TNC and other clinical indicators were assessed by Spearman's rho test.The receiver operating characteristic(ROC)curve was drawn to assess the discriminative ability of serum TNC to determine CAS in individuals with T2DM.Results Patients with elevated CIMT had significantly higher serum TNC levels[plaque formation group 137.20(119.11,150.36)ng/L vs.intimal thickening group 121.64(101.18,141.75)ng/L vs.normal group 110.63(84.59,125.38)ng/L,P<0.001].In addition,CIMT increased with ascending TNC(P for trend<0.001).In logistic regression models,TNC was also established to be an independent risk factor for the increased CIMT in T2DM patients.Moreover,the spearman correlation analysis showed that serum TNC level was positively correlated with body mass index and waist circumference.ROC curve analysis demonstrated that the area under curve(AUC)value for TNC.Serum TNC was a good predictor for CAS occurrence.When the cutoff value for TNC was 125.38 ng/L,its sensitivity was 77%while its specificity was 59%.Conclu⁃sion Elevated serum TNC level is independently associated with the increased CIMT in individuals with T2DM.Therefore,this biomarker might be considered as one of the potential diagnostic indicators for CAS in type 2 diabetics.