血清Sestrin2和Nrg-4在2型糖尿病合并冠心病患者中的表达及诊断价值分析

Expressions and diagnostic value of serum Sestrin2 and neuregulin4 in patients with type 2 diabetes mellitus complicated by coronary heart disease

目的探究血清Sestrin2和神经调节蛋白4(Nrg-4)对2型糖尿病合并冠状动脉粥样硬化性心脏病(T2DM-CHD)患者的临床价值。方法选择2021年3月至2023年3月间于湖南省人民医院诊治2型糖尿病患者,根据是否合并冠心病(CHD)分为CHD组及非CHD组,对其血清Sestrin2和Nrg-4水平进行检测,分析患者血清Sestrin2和Nrg-4水平和临床相关指标的相关性,采用受试者工作特征(ROC)曲线分析其对2型糖尿病合并冠心病的预测价值。结果共纳入102例2型糖尿病患者(其中52例为CHD组,50例为非CHD组)。CHD组患者血清Sestrin2和Nrg-4表达水平显著低于非CHD组患者(P<0.05)。Pearson相关分析表明,血清Sestrin2和Nrg-4水平与糖尿病病程(r=-0.671,P<0.001;r=-0.792,P<0.001)、空腹血糖(FPG,r=-0.577,P<0.001;r=-0.737,P<0.001)、糖化血红蛋白(HbA1c,r=-0.659,P<0.001;r=-0.714,P<0.001)、三酰甘油(TG,r=-0.714,P<0.001;r=-0.720,P<0.001)呈负相关,与高密度脂蛋白胆固醇(HDL-C)呈正相关(r=0.725,P<0.001;r=0.688,P<0.001)。Logistic回归分析结果表明,血清Sestrin2(OR:0.73,95%CI:0.647~0.821,P<0.001)和Nrg-4(OR:0.78,95%CI:0.718~0.844,P<0.001)是T2DM-CHD的保护因素;ROC曲线结果显示,血清Sestrin2和Nrg-4联合检测的曲线下面积(AUC)为0.862,大于Sestrin2、Nrg-4单独检测的曲线下面积,灵敏度、特异度分别为86.00%和80.77%。结论2型糖尿病患者血清Sestrin2与Nrg-4水平与CHD相关,且Sestrin2与Nrg-4联合检测对于T2DM-CHD具有较高的预测价值。

Objective To investigate the clinical value of Sestrin2 and neuregulin4(Nrg-4)in patients with type 2 diabetes mellitus complicated by coronary heart disease(T2DM-CHD).Methods T2DM patients were chosen and divided,according to whether they had CHD or not,into CHD group and non-CHD group in People's Hospital of Hunan Province from Mar.2021 to Mar.2023.The levels of Sestrin2 and Nrg-4 were detected in 2 groups,and correlation among Sestrin2,Nrg-4 and clinical relative indexes were analyzed.The predictive value of Sestrin2 and Nrg-4 to T2DM-CHD was analyzed by using ROC curve.Results There were totally 102 T2DM patients chose(52 in CHD group and 50 in non-CHD group).The expressions of Sestrin2 and Nrg-4 were significantly lower in CHD group than those in non-CHD group(P<0.05).The results of Pearson correlation analysis showed that levels of serum Sestrin2 and Nrg-4 were negatively correlated to diabetes course(r=-0.671,P<0.001;r=-0.792,P<0.001),fasting plasma glucose(FPG,r=-0.577,P<0.001;r=-0.737,P<0.001),glycated hemoglobin(HbAlc,r=-0.659,P<0.001;r=-0.714,P<0.001)and triglyceride(TG,r=-0.714,P<0.001;r=-0.720,P<0.001),and positively correlated to high-density lipoprotein-cholesterol(HDL-C,r=0.725,P<0.001;r=0.688,P<0.001).The results of Logistic regression analysis showed that Sestrin2(OR=0.73,95%CI:0.647~0.821,P<0.001)and Nrg-4(OR=0.78,95%CI:0.718~0.844,P<0.001)were protective factors for T2DM-CHD.The results of ROC curve analysis showed that AUC of Sestrin2 combined with Nrg-4 was 0.862,which was higher than that of single Sestrin2 or single Nrg-4 in predicting T2DM-CHD,and sensitivity was 86.00%and specificity was 80.77%.Conclusion The levels of serum Sestrin2 and Nrg-4 are correlated to CHD in T2DM patients,and Sestrin2 combined with Nrg-4 has a higher predictive value to T2DM-CHD.