糖尿病足患者血清分泌卷曲相关蛋白4、半乳糖凝集素3的水平及其临床意义

Levels of serum secreted frizzled related protein 4,galectin 3 in patients with diabetic foot and their clinical significance

目的 探讨糖尿病足患者血清分泌卷曲相关蛋白4(SFRP4)、半乳糖凝集素3(Gal-3)的水平及其临床意义。方法 选取100例糖尿病足患者作为糖尿病足组,并根据Wagner分级进一步将其分为轻度组34例、中度组43例、重度组23例。另选取同期100例无糖尿病足的2型糖尿病患者作为对照组。采用ELISA检测患者血清SFRP4、Gal-3水平。采用多因素Logistic回归模型分析2型糖尿病患者发生糖尿病足的影响因素。采用受试者工作特征(ROC)曲线评价血清SFRP4、Gal-3水平对2型糖尿病患者发生糖尿病足的预测价值。结果 糖尿病足组患者的尿微量白蛋白/肌酐,血清白细胞介素(IL)-1β、IL-6、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、SFRP4、Gal-3水平高于对照组(P<0.05)。相较于轻度组,中度组和重度组患者血清SFRP4、Gal-3水平升高(P<0.05);相较于中度组,重度组患者血清SFRP4、Gal-3水平升高(P<0.05)。多因素Logistic回归分析结果显示,血清IL-1β、TNF-α、SFRP4、Gal-3水平是2型糖尿病患者发生糖尿病足的影响因素(P<0.05)。ROC曲线分析结果显示,血清SFRP4、Gal-3水平单独及联合预测糖尿病足发生的曲线下面积分别为0.788、0.781、0.862,其中二者联合预测的曲线下面积大于血清SFRP4、Gal-3水平单独预测(P<0.05)。结论 糖尿病足患者血清SFRP4、Gal-3水平上升,且与糖尿病足的严重程度密切相关,均为2型糖尿病患者发生糖尿病足的影响因素,二者联合预测糖尿病足发生的效能较高。

Objective To investigate the levels of serum secreted frizzled related protein 4(SFRP4) and galectin 3(Gal-3) in patients with diabetic foot and their clinical significance.Methods A total of 100 patients with diabetic foot were selected as the diabetic foot group,and they were further assigned to mild group(34 cases),moderate group(43 cases),or severe group(23 cases) according to the Wagner classification.Another 100 patients with type 2 diabetes mellitus without diabetic foot were selected as the control group during the same period.The levels of serum SFRP4 and Gal-3 were detected by the ELISA.The multivariate Logistic regression model was applied to analyze the influencing factors for the occurrence of diabetic foot in patients with type 2 diabetes mellitus.The receiver operating characteristic(ROC) curve was used to evaluate predictive value of serum SFRP4 and Gal-3 levels for the occurrence of diabetic foot in patients with type 2 diabetes mellitus.Results The levels of urinary microalbumin/creatinine,serum interleukin(IL)-1β,IL-6,tumor necrosis factor α(TNF-α),C-reactive protein(CRP),SFRP4,and Gal-3 in the diabetic foot group were higher than those in the control group(P<0.05).Compared with the mild group,serum SFRP4 and Gal-3 levels of the moderate group and the severe group were elevated(P<0.05);furthermore,compared with the moderate group,serum SFRP4 and Gal-3 levels in the severe group were elevated(P<0.05).The results of multivariate Logistic regression analysis revealed that serum IL-1β,TNF-α,SFRP4,and Gal-3 levels were the influencing factors for the occurrence of diabetic foot in patients with type 2 diabetes mellitus(P<0.05).The results of ROC curve analysis indicated that areas under the curve of serum SFRP4 and Gal-3 levels for alone and jointly predicting the occurrence of diabetic foot were 0.788,0.781,and 0.862,respectively,therein,area under the curve of the combined prediction of the two was larger than that of the single prediction of serum SFRP4 and Gal-3 levels(P<0.05).Conclusion Serum SFRP4,Gal-3 levels in patients with diabetic foot are elevated,which are closely related to diabetic foot severity,and they are all the influencing factors for the occurrence of diabetic foot in patients with type 2 diabetes mellitus.The combined prediction of the two for predicting the occurrence of diabetic foot exerts relatively high efficiency.