不同糖尿病微血管病变患者血清N-钙黏蛋白、E-钙黏蛋白水平变化及其诊断效能分析

Changes of serum N-cadherin and E-cadherin in patients with different diabetic microangiopathy and their diagnostic efficacy

目的观察不同糖尿病微血管病变患者血清N-钙黏蛋白(N-cadherin)、E-钙黏蛋白(E-cadherin)水平变化,探讨N-cadherin、E-cadherin对糖尿病微血管病的诊断效能。方法选择2型糖尿病240例,其中单纯糖尿病、糖尿病视网膜病变(DR)、糖尿病肾病(DKD)、DR合并DKD各60例,分别纳入糖尿病组、DR组、DKD组、DR合并DKD组;选择60例健康人群纳入对照组。采用ELISA法检测血清N-cadherin、E-cadherin,分析血清N-cadherin、E-cadherin与糖尿病患者实验室检查指标的相关性,采用受试者工作特征(ROC)曲线分析N-cadherin、E-cadherin对2型糖尿病微血管病变的诊断价值。结果糖尿病各组血清N-cadherin水平高于对照组,DR组、DKD组、DR合并DKD组血清N-cadherin水平高于糖尿病组(P均<0.05)。糖尿病各组血清E-cadherin水平低于对照组,DR组、DKD组、DR合并DKD组血清E-cadherin水平低于糖尿病组(P均<0.05)。DR组中,增殖期患者血清N-cadherin水平高于非增殖期患者(P<0.05)。血清N-cadherin与糖尿病患者病程、PBG、UAER呈正相关(rs分别为0.450、0.205、0.375),与LDL、E-cadherin呈负相关(rs分别为-0.218、-0.475);血清E-cadherin与糖尿病患者病程、N-cadherin呈负相关(rs分别为-0.360、-0.475),与UAER、LDL、TC呈正相关(rs分别为0.375、0.205、0.170)。病程、UAER、LDL、N-cadherin是2型糖尿病微血管病变共同的影响因素(P均<0.05)。血清N-cadherin、E-cadherin对单纯糖尿病及糖尿病微血管病变的诊断效能均较好。结论与单纯糖尿病患者相比,糖尿病微血管病变患者血清N-cadherin水平升高、E-cadherin水平降低,与患者糖尿病微血管病变发病相关因素密切相关。血清N-cadherin、E-cadherin有望作为糖尿病微血管病变早期诊断的指标。

Objective To observe the changes in levels of serum N-cadherin and E-cadherin in patients with different diabetic microangiopathy,and to investigate the diagnostic effectiveness of N-cadherin and E-cadherin in diabetic microangiopathy.Methods Totally 240 cases of type 2 diabetes mellitus were selected,including 60 cases of simple diabetes,60 cases of diabetic retinopathy(DR),60 cases of diabetic nephropathy(DKD),and 60 cases of DR combined with DKD,which were taken as the diabetes group,DR group,DKD group,and DR combined with DKD group,respectively;60 healthy people were selected in the control group.Serum N-cadherin and E-cadherin were detected by ELISA.The correlations between serum N-cadherin and E-cadherin and laboratory examination indicators for diabetic patients were analyzed,and the diagnostic value of N-cadherin and E-cadherin in diabetic microangiopathy of type 2 diabetes mellitus was analyzed by the receiver operating characteristic(ROC)curve.Results The serum N-cadherin level of each diabetes group was higher than that in the control group,and the serum N-cadherin levels of the DR group,DKD group and DR combined with DKD group were higher than that in the diabetes group(all P<0.05).The serum E-cadherin level of each diabetes group was lower than that of the control group,and the serum E-cadherin levels of the DR group,DKD group and DR combined with DKD group were lower than that of the diabetes group(all P<0.05).In the DR group,the level of Ncadherin in proliferative patients was higher than that of non-proliferative patients(P<0.05).Serum N-cadherin was positively correlated with the course of diabetes,PBG,and UAER(rs=0.450,0.205,and 0.375),and was negatively correlated with LDL and E-cadherin(rs=-0.218,-0.475);serum E-cadherin was negatively correlated with the course of diabetes,N-cadherin(rs=-0.360,-0.475),and was positively correlated with UAER,LDL and TC(rs=0.375,0.205,and 0.170).Course of the disease,UAER,LDL and N-cadherin were the co-influencing factors for diabetic microangiopathy in type 2 diabetes mellitus(all P<0.05).Serum N-cadherin and E-cadherin were more effective in diagnosing diabetes mellitus and diabetic microangiopathy.Conclusions Compared with simple diabetes patients,the serum N-calcium level of patients with diabetic microangiopathy increases and the level of E-cadherin decreases;N-cadherin and E-cadherin are closely related to the incidence of diabetic microangiopathy in patients.Serum N-cadherin and E-cadherin are expected to be used as indicators for the early diagnosis of diabetic microangiopathy.