血清RBP、Cys-C与2型糖尿病伴高血压患者颈动脉病变的相关性

Correlation of Serum RBP,Cys-C and Carotid Artery Lesions in Type 2 Diabetes Mellitus Patients with Hypertension

目的分析血清视黄醇结合蛋白(RBP)、胱抑素(Cys-C)与2型糖尿病(T2DM)伴高血压患者颈动脉病变的相关性。方法选取2020年3月至2022年9月在郑州大学第三附属医院就诊的T2DM伴高血压患者150例作为观察组,另选取同期在医院就诊的单纯T2DM患者50例作为对照组,收集两组患者的一般资料,检测RBP、Cys-C、血糖以及各项生化指标[糖化血红蛋白(HbA1c)、肌酐(Cr)、尿素氮(BUN)、丙氨酸转氨酶(ALT)、门冬氨酸氨基转移酶(AST)、甘油三酯(TG)、总胆固醇(TC)、高/低密度脂蛋白胆固醇(H/LDL-C)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、同型半胱氨酸(Hcy)]水平。依据颈动脉内膜厚度将T2DM伴高血压患者分为颈动脉内膜正常组、增厚组以及斑块组,分析不同组别RBP、Cys-C水平的差异性,绘制受试者工作特征(ROC)曲线分析RBP、Cys-C在T2DM伴高血压患者颈动脉病变中的诊断价值。结果观察组患者的血Cr、BUN、LDH、CK、Hcy、Cys-C和RBP水平均较对照组高(P<0.05)。在Cys-C、RBP水平比较上,颈动脉中层内膜正常组<增厚组<斑块组(P<0.05)。Spearman相关性分析显示,Cys-C、RBP分别与脉中层内膜厚度呈正相关(r=0.578,0.436,P<0.05)。Cys-C、RBP联合诊断T2DM伴高血压患者颈动脉病变的曲线下面积为0.940(0.890~0.972),灵敏度与特异度分别为0.861、0.886(P<0.05),其诊断效能均优于Cys-C、RBP单一指标检测(P<0.05)。结论T2DM伴高血压患者Cys-C、RBP水平与颈动脉内膜中层厚度呈正相关,且二者联合检测在T2DM伴高血压患者颈动脉病变的诊断中具有良好的效能。

Objective To analyze the correlation between serum retinol-binding protein(RBP),cystatin(Cys-C)and carotid artery disease in patients with type 2 diabetes mellitus(T2DM)and hypertension.Methods A total of 150 T2DM patients with hypertension admitted to the Third Affiliated Hospital of Zhengzhou University from March 2020 to September 2022 were selected as observation group,and 50 simple T2DM patients admitted to the hospital during the same period were selected as control group.General data of the two groups of patients were collected,and the levels of RBP,Cys-C,blood glucose and various biochemical indicators[glycosylated hemoglobin A1c(HbA1c),creatinine(Cr),blood urea nitrogen(BUN),alanine aminotransferase(ALT),aspartate aminotransferase(AST),triglyceride(TG),total cholerterol(TC),high/low density lipoprotein cholesterol(H/LDL-C),lactate dehydrogenase(LDH),creatine kinase(CK),homocysteine(Hcy)]were detected.According to carotid intima thickness,T2DM patients with hypertension were divided into normal carotid intima group,thicken carotid intima group and plaque group.Differences in RBP and Cys-C levels in different groups were analyzed,and receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic value of RBP and Cys-C in carotid artery lesions in T2DM patients with hypertension.Results The levels of serum Cr,BUN,LDH,CK,Hcy,Cys-C and RBP in observation group were higher than those in control group(P<0.05).Compared with the levels of Cys-C and RBP,normal carotid media intima group<thickening group<plaque group(P<0.05).Spearman correlation analysis showed that Cys-C and RBP were positively correlated with the thickness of the media intima,respectively(r=0.578,0.436,P<0.05).The area under the curve of Cys-C combined with RBP in the diagnosis of carotid artery disease in T2DM patients with hypertension was 0.940(0.890-0.972),and the sensitivity and specificity were 0.861 and 0.886(P<0.05).The diagnostic efficacy of Cys-C combined with RBP was superior to that of Cys-C and RBP single index detection(P<0.05).Conclusion In T2DM patients with hypertension,the levels of Cys-C and RBP are positively correlated with carotid intima-media thickness,and the combined detection of Cys-C and RBP has good efficacy in the diagnosis of carotid artery disease in T2DM patients with hypertension.