血清半乳糖凝集素3、25羟维生素D3、中性粒细胞与淋巴细胞比值对2型糖尿病患者下肢血管病变血管介入疗效的评估价值

Value of serum galactoagglutinin 3,25 hydroxyvitamin D3 and neutrophil to lymphocyte ratio in evaluating vascular interventional efficacy of lower extremity vascular disease in type 2 diabetes mellitus

目的探讨血清半乳糖凝集素3(Gal-3)、25羟维生素D3[25(OH)D3]、中性粒细胞与淋巴细胞比值(NLR)对T2DM患者下肢血管病变(LEAD)血管介入疗效的评估价值。方法选取2021年2月至2022年3月于我院收治的T2DM合并LEAD患者(T2DM+LEAD组),和同期收治未合并LEAD的T2DM患者(T2DM组),及未合并T2DM的LEAD患者(LEAD组),每组各60例。比较各组血清Gal-3、25(OH)D3、中性粒细胞与淋巴细胞计数比值(NLR)。结果T2DM+LEAD组入院时他汀药、降脂药、抗凝药使用率、动脉粥样硬化指数、Gal-3、NLR高于T2DM、LEAD组(P<0.05),FPG、HbA_(1)c、25(OH)D3低于T2DM、LEAD组(P<0.05)。T2DM患者血清Gal-3、25(OH)D3、NLR处于高水平时,LEAD患病风险分别是低水平的4.667、0.209、3.500倍。T2DM患者LEAD血管介入治疗后无效亚组血清Gal-3、NLR高于有效亚组(P<0.05),25(OH)D3及Gal-3、25(OH)D3、NLR手术前后差值绝对值低于有效亚组(P<0.05)。Logistic回归分析显示,Gal-3、25(OH)D3、NLR手术前后差值绝对值是T2DM患者LEAD血管介入疗效的影响因素。受试者工作特征(ROC)曲线分析显示,血清Gal-3、25(OH)D3、NLR手术前后差值绝对值评估T2DM患者LEAD血管介入疗效的ROC曲线下面积(AUC)为0.780、0.741、0.755,联合评估的AUC为0.925(P<0.001)。结论T2DM合并LEAD患者血清Gal-3、NLR升高,25(OH)D3降低,Gal-3、25(OH)D3、NLR手术前后差值绝对值与T2DM患者LEAD血管介入疗效相关。

Objective To explore the value of serum galactoagglutinin 3(Gal-3),25 hydroxyvitamin D3[25(OH)D3]and neutrophil to lymphocyte ratio(NLR)in evaluating the vascular interventional efficacy of lower extremity vascular disease(LEAD)in type 2 diabetes mellitus(T2DM).Methods Sixty patients with T2DM combined with LEAD(T2DM+LEAD group)admitted to our hospital were enrolled in this study from February 2021 to March 2022.Meanwhile,60 patients with T2DM and without LEAD(T2DM group)and 60 patients with LEAD and without T2DM(LEAD group)were enrolled.Serum Gal-3,25(OH)D3,NLR were compared among the groups.Results The rates of statins,other lipid-lowering drugs,anticoagulants treatment,AIP,Gal-3,and NLR were higher,while FPG,HbA_(1)c,25(OH)D3 were lower in T2DM+LEAD group than in T2DM and LEAD groups at admission(P<0.05).When serum Gal-3,25(OH)D3,and NLR levels were at high level in T2DM patients,the risk of LEAD is 4.667,0.209,and 3.500 times higher than that of low levels.After LEAD vascular intervention therapy,levels of serum Gal-3 and NLR were higher in the ineffective subgroup of T2DM patients than in the effective subgroup(P<0.05),while the absolute values of 25(OH)D3 and Gal-3,25(OH)D3 and NLR before and after surgery were lower in the ineffective subgroup than in the effective subgroup(P<0.05).Logistic regression analysis showed that the absolute difference between Gal-3,25(OH)D3,and NLR before and after surgery was a influencing factor for the efficacy of LEAD vascular intervention in T2DM patients.The analysis of the receiver operating characteristic(ROC)curve showed that the area under the ROC curve(AUC)of the absolute difference between serum Gal-3,25(OH)D3,and NLR before and after surgery was 0.780,0.741,0.755 in evaluating the efficacy of LEAD vascular intervention in T2DM patients,and the AUC of the combined evaluation was 0.925(P<0.001).Conclusion Gal-3 and NLR increased and 25(OH)D3 decreased in T2DM patients with lower extremity vascular lesions,and the absolute difference values of Gal-3,25(OH)D3 and NLR before and after surgery are related to the efficacy of vascular intervention in T2DM patients with LEAD.