血清WISP1水平与2型糖尿病合并颈动脉粥样硬化患者颈动脉斑块形成的关系

Relationship between serum WISP1 level and formation of carotid plaque in patients with type 2 diabetes mellitus and carotid atherosclerosis

目的探讨2型糖尿病(T2DM)合并颈动脉粥样硬化患者血清Wnt1诱导型信号通路蛋白1(WISP1)水平与颈动脉斑块形成的关系。方法108例T2DM合并颈动脉粥样硬化患者,根据超声颈动脉内膜中层厚度分为内膜增厚组(38例)和斑块形成组(70例)。记录患者相关临床资料,采用ELISA法检测血清WISP1水平。分析WISP1与临床指标的相关性,多因素logistic回归分析T2DM合并颈动脉粥样硬化患者颈动脉斑块形成的影响因素,ROC曲线评估血清WISP1水平对颈动脉斑块形成的诊断价值。结果与内膜增厚组相比,斑块形成组T2DM病程更长,SBP、血清WISP1水平更高,肌肉总质量、躯干肌肉质量、四肢肌肉质量及四肢骨骼肌质量指数更少(P<0.05)。血清WISP1水平与腰围、臀围、腰臀比、HbA1c水平、25-羟维生素D水平、体脂肪质量呈正相关(r_(s)=0.472、0.287、0.422、0.223、0.217、0.230,P<0.05)。T2DM病程增加、血清WISP1水平升高是T2DM合并颈动脉粥样硬化患者颈动脉斑块形成的独立危险因素(P<0.05)。血清WISP1水平诊断T2DM合并颈动脉粥样硬化患者颈动脉斑块形成的AUC为0.648[95%CI(0.532~0.764),P<0.05]。结论血清WISP1水平与T2DM合并颈动脉粥样硬化患者颈动脉斑块形成密切相关,可能是诊断颈动脉斑块形成的潜在生物标志物。

Objective To investigate the relationship between serum Wnt1 inducible signal pathway protein 1(WISP1)level and the formation of carotid plaque in the patients with type 2 diabetes mellitus(T2DM)and carotid atherosclerosis.Methods A total of 108 patients with T2DM and carotid atherosclerosis were divided into two groups of A(with intima thickening,38 cases)and B(with plaque formation,70 cases)on the basis of carotid intima-media thickness measured by ultrasound.The clinical data were recorded,and serum WISP1 level was detected by ELISA method.The correlation between serum WISP1 level and relevant clinical indexes was analyzed by Spearman correlation analysis.The influencing factors for the formation of carotid plaque in the patients with T2DM and carotid atherosclerosis were analyzed by multivariate logistic regression.The diagnostic value of serum WISP1 level in the formation of carotid plaque was evaluated by ROC curve.ResultsCompared with group A,the duration of T2DM was longer,SBP and serum WISP1 level were higher,and total mass of muscles,mass of trunk muscles,mass of limbs muscles and skeletal muscle mass index were less in group B(P<0.05).Serum WISP1 level was positively correlated with waist circumference,hip circumference,waist-to-hip ratio,HbA1c level,25-(OH)D level and mass of body fat(r_(s)=0.472,0.287,0.422,0.223,0.217 and 0.230,P<0.05).The increased duration of T2DM and serum WISP1 level were the independent risk factors for the formation of carotid plaque in the patients with T2DM and carotid atherosclerosis(P<0.05).The AUC value of serum WISP1 level in the diagnosis of formation of carotid plaque in the patients with T2DM and carotid atherosclerosis was 0.648[95%CI(0.532-0.764),P<0.05].Conclusion Serum WISP1 level is closely correlated with the formation of carotid plaque in the patients with T2DM and carotid atherosclerosis,and may be a potential biomarker for diagnosing the formation of carotid plaque.