血清ACE、补体C1q对2型糖尿病并发下肢动脉硬化闭塞症的诊断价值

Diagnostic Value of Serum ACE and Complement C1q in Type 2 Diabetes Mellitus Complicated with Arteriosclerosis and Occlusion of Lower Limbs

目的 研究血清血管紧张素转换酶(ACE)、补体C1q对2型糖尿病(T2DM)并发下肢动脉硬化闭塞症(ASO)的诊断价值。方法 选取2022年2月至2023年9月于首都医科大学石景山教学医院/北京市石景山医院治疗的122例T2DM患者作为研究对象,根据是否并发ASO分为未并发ASO组82例与并发ASO组40例。收集所有患者的临床资料,比较2组血清ACE、补体C1q水平。采用受试者工作特征(ROC)曲线评价血清ACE、补体C1q对T2DM患者并发ASO的诊断价值,采用多因素Logistic回归分析T2DM患者并发ASO的影响因素。结果 并发ASO组患者血清ACE、补体C1q水平均高于未并发ASO组,差异均有统计学意义(P <0.05)。血清ACE、补体C1q诊断T2DM患者并发ASO的ROC曲线下面积(AUC)分别为0.817 (95%CI:0.772~0.862)、0.739 (95%CI:0.691~0.784),两者联合诊断的AUC为0.908 (95%CI:0.863~0.954)。并发ASO组患者空腹血糖水平、低密度脂蛋白胆固醇(LDL-C)水平、糖化血红蛋白(HbAc1)水平、糖尿病周围神经病变比例均高于未并发ASO组患者,差异有统计学意义(P <0.05)。糖尿病周围神经病变(OR=2.782,95%CI:1.290~5.997),血清ACE≥46.02 U/L (OR=4.651,95%CI:2.115~10.226),血清补体C1q≥181.24 mg/L (OR=3.557,95%CI:1.753~7.218)是T2DM患者并发ASO的影响因素(P <0.05)。结论 血清ACE和补体C1q水平在T2DM并发ASO患者中显著升高,二者可作为诊断T2DM患者并发ASO的潜在生物学指标,且联合应用的效能更高。

Objective To investigate the diagnostic value of serum angiotensin-converting enzyme(ACE)and complement C1q in patients with type 2 diabetes mellitus(T2DM)complicated with lower extremity arteriosclerosis and cclusion(ASO).Methods 122 patients with T2DM who were treated at Shijingshan Teaching Hospital of Capital Medical University from February 2022 to September 2023 were selected as the study subjects.They were divided into an uncomplicated ASO group of 82 cases and a combined ASO group of 40 cases based on whether they had ASO.Clinical data were collected from all patients,and the serum ACE and complement C1q levels between the two groups were compared.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum ACE and complement C1q for ASO in T2DM patients.Multivariate logistic regression analysis was performed to explore the influencing factors of ASO in T2DM patients.Results The levels of serum ACE and complement C1q in patients with concurrent ASO were higher than those in patients without ASO(all P<0.05).The AUC of serum ACE and complement C1q in T2DM cases with ASO was 0.817(95%CI:0.772~0.862)and 0.739(95%CI:0.691~0.784),respectively,and the AUC of serum ACE and complement C1q for T2DM patients with ASO was 0.908(95%CI:0.863~0.954).The proportion of fasting blood glucose level,LDL-C level,HbA1c level,and diabetic peripheral neuropathy in the ASO group were higher than those in the non-ASO group(all P<0.05).Diabetic peripheral neuropathy(OR=2.782,95%CI:1.290~5.997),serum ACE≥46.02 U/L(OR=4.651,95%CI:2.115~10.226),serum complement C1q≥181.24 mg/L(OR=3.557,95%CI: 1.753 ~ 7.218 ) were the influential factors for ASO in T2DM cases ( all P < 0.05 ) . Conclusion The levels of serumACE and complement C1q are significantly elevated in patients with T2DM combined with ASO. These two indicators can serve aspotential biological markers for diagnosing ASO in T2DM patients, and their combined use is more effective.