血清IgG亚型与2型糖尿病患者冠状动脉粥样硬化相关性的研究

The correlation between serum IgG subtype and coronary arteriosclerosis in patients with type 2 diabetes mellitus

目的探讨血清IgG亚型与T2DM患者冠状动脉粥样硬化(CAS)的相关性。方法选取2020年7月至2021年6月于南华大学附属第一医院内分泌代谢科就诊的T2DM患者41例,根据有无冠状动脉斑块分为单纯T2DM组(T2DM,n=12)和T2DM合并CAS组(CAS,n=29),比较两组血清IgG1、IgG2、IgG3及IgG4,受试者工作特征(ROC)曲线评估各指标对T2DM合并CAS的诊断价值。结果与T2DM组比较,CAS组年龄升高,TC、淋巴细胞比例、血Ca^(2+)降低(P<0.05)。CAS组IgG1、IgG3高于T2DM组(P<0.05)。ROC曲线分析显示,IgG1的ROC曲线下面积(AUC)为0.509(P=0.0805),敏感度0.552,特异度0.626。IgG3的AUC为0.727(P=0.0236),敏感度0.582,特异度0.656。组合7(IgG1、IgG3、年龄、淋巴细胞比例、血Ca^(2+)、TC)的AUC为0.8519。结论IgG1和IgG3是T2DM患者CAS的危险因素,组合7是预测T2DM合并CAS的理想模型。

Objective To analyze the correlation between serum IgG subtype and coronary arterio⁃sclerosis(CAS)in patients with type 2 diabetes mellitus(T2DM).Methods 41 T2DM patients were selected from the department of endocrine metabolism in the First Affiliated Hospital of University of South China from July 2020 to June 2021.According to the presence or absence of coronary artery plaque,they were divided into pure T2DM group(T2DM,n=12)and T2DM combined with CAS group(CAS,n=29).The levels of serum IgG1,IgG2,IgG3 and IgG4 between the two groups were compared.The diagnostic value of each index on T2DM combined with CAS was evaluated by the working characteristic(ROC)curve.Results Compared with T2DM group,the age of CAS group increased,the levels of TC,lymphocyte ratio and blood calcium decreased(P<0.05).IgG1 and IgG3 in CAS group were higher than those in T2DM group(P<0.05).The ROC curve analysis showed that the area under ROC curve(AUC)of IgG1 was 0.509(P=0.0805),with the sensitivity 0.552 and the specificity 0.626,respectively.The AUC of IgG3 was 0.727(P=0.0236),with the sensitivity 0.582 and the specificity 0.656,respectively.The AUC of combination 7(IgG1,IgG3,age,lymphocyte ratio,blood calcium and TC)was 0.8519.Conclusion IgG1 and IgG3 were the risk factors of T2DM with CAS.The combination 7 may be an ideal model to predict T2DM with CAS.