血清可溶性B7-H3对2型糖尿病合并颈动脉粥样硬化的诊断价值

Diagnostic Value of Serum Soluble B7-H3 in Type 2 Diabetes Mellitus Complicated with Carotid Atherosclerosis

目的探讨血清可溶性B7-H3(sB7-H3)对2型糖尿病(T2DM)合并颈动脉粥样硬化(CAS)的诊断价值。方法选取2019年9月至2020年8月在泰州市人民医院内分泌科就诊的100例T2DM患者作为研究对象,依据颈动脉超声检查结果分为T2DM合并CAS组(43例)和T2DM无CAS组(57例);另选取同期50例健康体检者作为正常对照组。采用酶联免疫吸附法测定血清sB7-H3水平。比较三组sB7-H3、血糖、血脂水平的变化;采用多因素Logistic回归分析影响T2DM合并CAS的危险因素;采用受试者工作特征曲线分析血清sB7-H3对T2DM合并CAS的诊断价值。结果T2DM合并CAS组和T2DM无CAS组血清sB7-H3、空腹血糖、餐后2 h血糖、LDL-C、TC和TG水平高于正常对照组(P<0.05),且T2DM合并CAS组血清sB7-H3、餐后2 h血糖、LDL-C、TC和TG水平高于T2DM无CAS组(P<0.05)。T2DM合并CAS组和T2DM无CAS组空腹血糖、HDL-C水平低于正常对照组(P<0.05),T2DM合并CAS组空腹血糖、HDL-C水平低于T2DM无CAS组(P<0.05)。T2DM合并CAS组年龄大于T2DM无CAS组(P<0.01),sB7-H3、餐后2 h血糖、LDL-C、TC、TG水平高于T2DM无CAS组(P<0.01),空腹血糖、HDL-C水平低于T2DM无CAS组(P<0.01)。Logistic回归分析显示,年龄增加,sB7-H3、餐后2 h血糖、LDL-C、TC水平升高,空腹血糖、HDL-C水平降低是T2DM患者发生CAS的危险因素(P<0.05)。血清sB7-H3诊断T2DM合并CAS的灵敏度为75.00%,特异度为68.42%。结论血清sB7-H3水平升高是T2DM合并CAS的危险因素,其诊断T2DM合并CAS的灵敏度和特异度较高。

Objective To investigate the diagnostic value of serum soluble B7-H3(sB7-H3)in type 2 diabetes mellitus(T2DM)complicated with carotid atherosclerosis(CAS).Methods A total of 100 patients with T2DM who visited the Department of Endocrinology of Taizhou People′s Hospital from Sep.2019 to Aug.2020 were included.According to the results of carotid artery ultrasonography,they were divided into a combined CAS group(43 cases)and a non-CAS group(57 cases);another 50 healthy subjects during the same period were included as a normal control group.Serum soluble B7-H3(sB7-H3)levels were determined by enzyme-linked immunosorbent assay.The changes of sB7-H3,blood glucose and blood lipid levels in the three groups were compared;the risk factors affecting T2DM combined with CAS were analyzed by multivariate Logistic regression;the diagnostic value of serum sB7-H3 in T2DM combined with CAS was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum sB7-H3,fasting blood glucose,2 h postprandial blood glucose,low density lipoprotein-cholesterol(LDL-C),total cholesterol(TC)and triglyceride(TG)in the combined CAS group and the non-CAS group were higher than those in the normal control group(P<0.05),and he levels of serum sB7-H3,2 h postprandial blood glucose,LDL-C,TC and TG in the combined CAS group were higher than those of the non-CAS group(P<0.05).The levels of fasting blood glucose and HDL-C in the combined CAS group and the non-CAS group were lower than those in the normal control group(P<0.05),and the fasting blood glucose and HDL-C levels in the combined CAS group were lower than those in the non-CAS group(P<0.05).The combined CAS group was older than the non-CAS group(P<0.01),and the levels of sB7-H3,2 h postprandial blood glucose,LDL-C,TC,and TG were higher than those in the non-CAS group(P<0.01),but fasting blood glucose,HDL-C levels were lower than those of the non-CAS group(P<0.01).Logistic regression analysis showed that increased age,increased levels of sB7-H3,2 h postprandial blood glucose,LDL-C and TC,and decreased fasting blood glucose and HDL-C were risk factors for CAS in T2DM patients(P<0.05).The sensitivity and specificity of serum sB7-H3 in the diagnosis of T2DM complicated with CAS were 75.00%and 68.42%respectively.Conclusion The increased level of sB7-H3 is a risk factor for T2DM complicated with CAS,and its sensitivity and specificity are high in the diagnosis of T2DM complicated with CAS.