糖尿病酮症酸中毒患者血清中FABP4、HbA1c表达与病情程度的相关性分析

Correlation between the expression of FABP4,HbA1c in serum and the severity of diabetic ketoacidosis

目的探究糖尿病酮症酸中毒(DKA)患者血清中脂肪型脂肪酸结合蛋白4(FABP4)、糖化血红蛋白(HbA1c)表达和病情程度的相关性。方法回顾性选取2021年2月至2023年2月北京市大兴区人民医院收治的DKA患者90例设为研究组;同期选择90例单纯糖尿病患者作为对照组。按照血pH值和碳酸氢根离子(HCO 3-)水平,将研究组分为轻度DKA组(n=30)、中度DKA组(n=38)和重度DKA组(n=22)。检测并比较3组DKA患者血清中FABP4、HbA1c水平;采用Spearman相关分析法分析血清FABP4、HbA1c表达与DKA患者病情程度的关系;Logistic回归分析DKA病情程度的影响因素。受试者操作特征(ROC)曲线分析血清FABP4、HbA1c水平对重度DKA患者的诊断价值。结果研究组的空腹血糖、血肌酐、血尿素氮水平均高于对照组,血pH值、HCO 3-水平均低于对照组,差异均有统计学意义(P<0.05)。研究组患者血清FABP4、HbA1c水平均高于对照组,差异均有统计学意义(P<0.05)。轻度、中度、重度DKA组患者血清FABP4、HbA1c水平均依次显著上升,差异均有统计学意义(P<0.05)。血清FABP4、HbA1c均和DKA病情程度之间呈正相关(r=0.578、0.496,P<0.05)。Logistic回归分析显示,血清FABP4、HbA1c是影响DKA患者病情程度的危险因素(P<0.05)。血清FABP4、HbA1c水平单独及二者联合诊断DKA患者重度病情的曲线下面积分别为0.911、0.827和0.941,二者联合优于血清HbA1c单独诊断(P<0.05)。结论FABP4、HbA1c在DKA患者血清中表达显著升高,与患者病情程度密切相关。

Objective To explore the correlation between the expression of fatty acid binding protein 4(FABP4)and glycated hemoglobin(HbA1c)in the serum of patients with diabetic ketoacidosis(DKA)and the severity of condition.Methods Ninety DKA patients accepted by Beijing Daxing District People's Hospital from Feburary 2021 to Feburary 2023 were collected as the research subjects and set up as a research group;meantime,90 patients with simple diabetes were regarded as the control group.According to blood pH and bicarbonate ion(HCO 3-)levels,the study group was separated into the mild DKA group(n=30),the moderate DKA group(n=38),and the severe DKA group(n=22).The levels of FABP4 and HbA1c in the serum of DKA patients in three groups were detected and compareed.The relationship between serum levels of FABP4 and HbA1c and the severity of DKA patients was analyzed by Spearman correlation analysis.The relevant influencing factors of the severity of DKA was analyzed by Logistic regression model.The diagnostic value of serum FABP4 and HbA1c levels in patients with severe DKA was analyzed by receiver operating characteristic(ROC)curve.Results The levels of fasting blood glucose,serum creatinine and blood urea nitrogen in the study group were higher than those in the control group,and the levels of blood pH and HCO 3-were lower than those in the control group,the differences were statistically significant(P<0.05).The levels of serum FABP4 and HbA1 c in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).The levels of FABP4 and HbA1c in the serum of mild,moderate,and severe DKA groups obviously increased in sequence,the differences were statistically significant(P<0.05).Serum FABP4 and HbA1c were positively correlated with the severity of condition(r=0.578,0.496,P<0.05).Logistic regression analysis showed that serum FABP4 and HbA1c were risk factors affecting the severity of DKA patients(P<0.05).The area under the curve values of serum FABP4 and HbA1c levels alone and in combination for diagnosing severe conditions in DKA patients were 0.911,0.827,and 0.941,respectively.The combination of the two was superior to the diagnosis of serum HbA1c alone(P<0.05).Conclusion The expressions of FABP4 and HbA1c in the serum of DKA patients are obviously increased,which are closely related to the severity of condition.