Role of serum β2-microglobulin, glycosylated hemoglobin, and vascular endothelial growth factor levels in diabetic nephropathy

BACKGROUND Diabetic nephropathy(DN)is a common complication of type 1 and type 2 diabetes that can lead to kidney damage and high blood pressure.Increasing evidence support the important roles of microproteins and cytokines,such asβ2-microglobulin(β2-MG),glycosylated hemoglobin(HbA1c),and vascular endothelial growth factor(VEGF),in the pathogenesis of this disease.In this study,we identified novel therapeutic options for this disease.AIM To analyze the guiding significance ofβ2-MG,HbA1c,and VEGF levels in patients with DN.METHODS A total of 107 patients with type 2 diabetes mellitus complicated with nephropathy and treated in our hospital from May 2018 to February 2021 were included in the study.Additionally,107 healthy individuals and 107 patients with simple diabetes mellitus were selected as the control groups.Changes inβ2-MG,HbA1c,and VEGF levels in the three groups as well as the different proteinuria exhibited by the three groups were examined.RESULTS Changes inβ2-MG,HbA1c,and VEGF levels in the disease,healthy,and simple diabetes groups were significantly different(P<0.05).The expression of these factors from high to low were evaluated in different groups by pairwise comparison.In the disease group,high to low changes inβ2-MG,HbA1c,and VEGF levels were noted in the massive proteinuria,microproteinuria,and normal urinary protein groups,respectively.Changes in these factors were positively correlated with disease progression.CONCLUSION The expression of serumβ2-MG,HbA1c,and VEGF was closely correlated with DN progression,and disease progression could be evaluated by these factors.

Interplay of serum biomarkers bilirubin andγ-glutamyltranspeptidase in predicting cardiovascular complications in type-2 diabetes mellitus

This editorial synthesizes insights from a series of studies examining the interplay between metabolic and oxidative stress biomarkers in cardiovascular disease(CVD),focusing particularly on type-2 diabetes mellitus(T2DM)and acute coronary syndrome(ACS).The central piece of this synthesis is a study that investigates the balance between oxidative stress and antioxidant systems in the body through the analysis of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)levels in T2DM patients with ACS.This study highlights serum bilirubin as a protective antioxidant factor,while elevatedγ-GGT levels indicate increased oxidative stress and correlate with major adverse cardiovascular events.Complementary to this,other research contributions revealγ-GGT’s role as a risk factor in ACS,its association with cardiovascular mortality in broader populations,and its link to metabolic syndrome,further elucidating the metabolic dysregulation in CVDs.The collective findings from these studies underscore the critical roles ofγ-GGT and serum bilirubin in cardiovascular health,especially in the context of T2DM and ACS.By providing a balanced view of the body’s oxidative and antioxidative mechanisms,these insights suggest potential pathways for targeted interventions and improved prognostic assessments in patients with T2DM and ACS.This synthesis not only corroborates the pivotal role ofγ-GGT in cardiovascular pathology but also introduces the protective potential of antioxidants like bilirubin,illuminating the complex interplay between T2DM and heart disease.These studies collectively underscore the critical roles of serum bilirubin andγ-GGT as biomarkers in cardiovascular health,particularly in T2DM and ACS contexts,offering insights into the body’s oxidative and antioxidative mechanisms.This synthesis of research supports the potential of these biomarkers in guiding therapeutic strategies and improving prognostic assessments for patients with T2DM and some CVD.

Serum tumor markers (carcinoembryonic antigen, carbohydrate antigen 19-9, carbohydrate antigen 72-4, carbohydrate antigen 24-2, ferritin) and gastric cancer prognosis correlation

BACKGROUND Gastric cancer is a kind of malignant tumor which is prevalent all over the world.Although some progress has been made in the treatment of gastric cancer,its prognosis is still not optimistic,so it is of great significance to find reliable prog-nostic indicators to guide the treatment and management of patients with gastric cancer.AIM To explore the relationship between serum levels of five biomarkers[carcinoem-bryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA72-4,CA24-2,and ferritin]and prognosis in patients with gastric cancer.METHODS This study included 200 patients with gastric adenocarcinoma,and conducted an in-depth analysis of their baseline characteristics,relationship between tumor markers and staging,and prognosis.The study found that CA19-9 has a signi-ficant correlation with tumor stage,the average levels of CA24-2,CEA,CA72-4 and ferritin were slightly increased disregarding the stage of tumor.Survival analysis showed that increases in CEA,CA19-9,CA24-2,and ferritin were all associated with shortened overall survival of patients.Further multivariate ana-lysis revealed that elevated serum CA72-4 levels were an inde-pendent adverse prognostic factor.RESULTS This study reveals that there is a significant correlation between the expression levels of serum tumor markers CEA,CA19-9,CA72-4,CA24-2 and ferritin in patients with gastric cancer and prognosis,and can be used as important indicators for prognostic evaluation of gastric cancer.In particular,markers that appear abnormally elevated initially may help identify gastric cancer patients with poor prognosis.CONCLUSION Serum CEA and CA19-9 play an important role in the prognosis assessment of gastric cancer,and are effective tools to guide clinical practice and optimize individualized treatment strategies for gastric cancer patients.

Study on the Hook Effect in the Detection of Beta2-Microglobulin with Different Reagents in Fully Automated Biochemical Analyzers

Objective:To investigate the hook effect in the detection of beta2-microglobulin(β2-MG)with different reagents as well as on two fully automated biochemical analyzers and their solutions.Methods:Using immunoturbidimetric assay forβ2-MG as the research object,β2-MG levels were detected by different concentration gradients ofβ2-microglobulin samples in Liedemann,Mack,and Myriad reagents of three manufacturers on two automatic biochemical analyzers,and the difference of the hook effect was comparatively analyzed.Results:Leadman reagent showed the hook effect on the Beckman AU5800 automated biochemistry analyzer,while both Maccura and Mindray reagents did not show the hook effect.After the experiments,we found the limit value of the pre-zone check of Leadman reagent,and changed the parameters of the instrument,when the limit value of the pre-zone check was reached,the instrument automatically diluted the specimen five times and then detected it again.After changing the parameters of the instrument,the correlation between the three methods of detecting samples of different concentrations was r>0.99.Conclusion:Before selecting the application of immunoturbidimetric reagents,we have to carry out the risk assessment of the hook effect and selectively set the parameters of the pre-zone check based on the highest concentration that may occur in the clinic;for the items that may have the hook effect,we have to selectively set the parameters of the pre-zone check when the ratio of average reaction rate and the immediate reaction rate is at the limit value,and the phenomenon of antigen excess may occur,the instrument will carry out automatic dilution before detection,so as to avoid the issuance of erroneous results of high-value samples due to the hook effect.

Clinical Observation of Serum Anti-PLA2R Antibody Levels in the Treatment of Idiopathic Membranous Nephropathy with Rituximab

Objective:To investigate the efficacy of rituximab in the treatment of idiopathic membranous nephropathy with varying levels of serum phospholipase A2 receptor antibodies.Methods:A total of 137 patients with idiopathic membranous nephropathy admitted to Beijing Sixth Hospital were selected.Based on their blood PLA2R antibody levels before rituximab treatment,patients were categorized into the PLA2R antibody positive group(n=94)and the PLA2R antibody negative group(n=43).They were followed up for at least 1 year,during which the efficacy,measured through 24-hour urine protein quantification and serum albumin levels,were compared between the two groups before and after treatment.Results:After 3 months of treatment,there was no significant difference in the quantitative levels of 24-hour urine protein between the two groups(P>0.05).However,after 6 and 12 months of treatment,there was a significant difference in the levels of 24-hour urine protein between the two groups(P<0.05).Additionally,after 3 months of treatment,there was a notable difference in the serum albumin levels between the two groups(P<0.05).However,after 6 and 12 months of treatment,there was no significant difference in serum albumin levels between the two groups(P>0.05).Analysis of complications in the two groups revealed that in the positive group,9 individuals experienced thrombosis,5 had infections,and 11 developed acute kidney injury(AKI).In contrast,in the negative group,5 individuals had thrombosis,2 had infections,and 3 developed AKI.There was no statistically significant difference in complications between the two groups(P>0.05).Conclusion:Serum anti-PLA2R antibody levels provide valuable insights into the clinical observation of rituximab treatment for idiopathic membranous nephropathy.They aid in understanding the disease’s pathogenesis,evaluating treatment efficacy,and predicting disease prognosis.

The clinical significance evaluation of serum β_2-microglobulin for thyroid cancer patients

Objective： The aim of this study was to investigate the clinical value and relevance on the serum β2-microglobulin （β2-MG） of patients with thyroid cancer. Methods： One thousand and two normal cases, 95 thyroid cancer patients and 243 nodular goiter patients were selected to measure serum β2-MG levels using double-antibody sandwich enzyme-linked immunosorbent assay （ELISA）. Results： The positive rate of 7.78% in normal population （78/1002） and 31.57% in thyroid cancer patients （30/95）. There were significant differences between the normal population and thyroid cancer patients （X2 = 55.352; P = 0.000）. The positive rate of 7.81% in nodular goiter patients （19/243） and there were no significant differences between the normal population and nodular goiter patients （X2 = 0.0004; P = 0.986）, but significant differences between nodular goiter patients and thyroid cancer patients （x2 = 31.106; P = 0.000）. Meanwhile, the significant difference of the positive rate existed in between the various pathological types of thyroid cancer （X2 = 10.015; P = 0.007）, anaplastic thyroid cancer patients with the highest positive rate and The significant difference was found between the positive lymph node metastasis groups and negative lymph node metastasis groups （x2 = 4.441; P = 0.035）, the presence of distant metastasis group and absence of distant metastasis group （X2 = 9.795; P = 0.002）. Conclusion： Serum β2-MG levels and prognosis of thyroid cancer patients was negatively correlated. It showed important clinical value to detect the level of β2-MG in the early diagnosis, prognosis and the clinical observation for thyroid cancer patients.

2型糖尿病伴干眼症病人血清和泪液分泌型卷曲相关蛋白5、脂肪酸结合蛋白4水平与病情严重程度的相关性

目的分析分泌型卷曲相关蛋白5(SFRP-5)、脂肪酸结合蛋白4(FABP4)在2型糖尿病(T2DM)伴干眼症病人血清和泪液中的表达及其与病情严重程度的相关性。方法选取2020年12月至2021年12月唐山市眼科医院收治的T2DM病人145例,其中单纯T2DM病人84例168眼(T2DM组),伴干眼症病人61例122眼(T2DM伴干眼症组),另选取同期该院体检健康者50例100眼作为对照组。T2DM伴干眼症病人又分为轻度组(29例)、中度组(17例)、重度组(15例)。利用酶联免疫吸附法测定所有受试者血清和泪液中SFRP-5、FABP4水平;相关性分析采用Pearson法或Spearman法;logistic回归分析影响T2DM病人干眼症发生的因素。结果T2DM伴干眼症组、T2DM组血清和泪液SFRP-5水平均低于对照组(106.09±8.37、135.72±9.26比158.34±9.45,28.85±5.13、58.27±6.14比45.18±5.92),T2DM伴干眼症组低于T2DM组(P<0.05);T2DM伴干眼症组、T2DM组血清和泪液FABP4水平均高于对照组(70.63±6.59、58.27±6.14比45.18±5.92,15.91±3.76、10.28±3.58比7.72±3.29),T2DM伴干眼症组高于T2DM组(P<0.05)。重度组、中度组血清和泪液SFRP-5水平(68.29±7.15、95.54±8.34比131.82±9.02,12.83±4.62、24.72±5.49比39.56±5.18)、泪膜破裂时间(BUT)、泪液分泌试验(SIT)低于轻度组,重度组低于中度组(P<0.05);重度组、中度组血清和泪液FABP4水平(84.56±6.83、73.18±6.94比61.93±6.27,25.64±4.19、17.15±3.86比10.16±3.47)及眼表疾病指数量表(OSDI)积分高于轻度组,重度组高于中度组(P<0.05)。T2DM伴干眼症病人血清与泪液SFRP-5水平呈正相关,血清与泪液FABP4水平也呈正相关(P<0.05)。T2DM伴干眼症病人血清和泪液SFRP-5水平与OSDI积分均呈负相关,与BUT、SIT均呈正相关(P<0.05);血清和泪液FABP4水平与OSDI积分均呈正相关,与BUT、SIT均呈负相关(P<0.05)。血清和泪液SFRP-5水平是影响T2DM病人干眼症发生的独立保护因素,而血清和泪液FABP4水平是独立危险因素(P<0.05)。结论SFRP-5在T2DM伴干眼症病人血清和泪液中均低表达,FABP4均高表达,二者与病情严重程度密切相关。

青海地区2型糖尿病患者血清胱抑素C及尿酸水平与骨密度的相关性分析

目的探究青海地区2型糖尿病(T_(2)DM)患者血清胱抑素C及尿酸水平与骨密度的相关性。方法选取2023年1—12月在青海省人民医院内分泌科就诊的T_(2)DM患者141例。根据骨质疏松症的诊断标准将患者分为骨量正常组(56例)、骨量减少组(53例)和骨质疏松组(32例),收集患者的一般资料,测定血清胱抑素C、尿酸等生化指标及骨密度数据,分析相关指标与骨密度的相关性。结果3组性别分布、年龄及25-羟维生素D、胱抑素C、总胆固醇、高密度脂蛋白胆固醇水平比较差异均有统计学意义(均P<0.05)。将单因素分析差异有统计学意义的变量作为自变量纳入多因素有序Logistic回归分析模型,分析结果显示,年龄、胱抑素C是T_(2)DM患者骨量减少及骨质疏松的危险因素,而男性、25-羟维生素D是其保护因素(比值比=0.434、0.922、1.100、3.555,均P<0.05)。结论高水平血清胱抑素C、女性、高龄、低水平25-羟维生素D可能是青海地区T_(2)DM患者骨量减少及骨质疏松症的危险因素,血尿酸水平与T_(2)DM患者骨密度变化无显著相关性。

老年2型糖尿病患者血清同型半胱氨酸、血清淀粉样蛋白A、S100β水平与颈动脉斑块稳定性的关系

目的探讨老年2型糖尿病患者血清同型半胱氨酸(Hcy)、血清淀粉样蛋白A(SAA)、S100β水平与颈动脉斑块稳定性的关系。方法选取2021年6月至2023年6月德阳市人民医院收治的186例老年2型糖尿病患者为病例组,同期体检的186例健康者为对照组,根据斑块情况将病例组患者分为不稳定斑块组57例,稳定斑块组32例,无斑块组97例。回顾性分析受试者血清Hcy、SAA、S100β水平及不稳定斑块组、稳定斑块组、无斑块组的临床资料。采用Spearman法分析老年2型糖尿病患者血清Hcy、SAA、S100β水平与颈动脉斑块稳定性的相关性,Logistic回归模型分析老年2型糖尿病患者颈动脉斑块稳定性的影响因素,ROC曲线分析Hcy、SAA、S100β评估老年2型糖尿病患者颈动脉不稳定斑块的效能。结果病例组患者血清Hcy、SAA、S100β水平高于对照组(t=28.737、40.946、57.982,P<0.05);不稳定斑块组、稳定斑块组、无斑块组三组间糖尿病病程、空腹血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白、Hcy、SAA、S100β差异有统计学意义(P<0.05);老年2型糖尿病患者血清Hcy、SAA、S100β水平均与颈动脉斑块的不稳定性呈正相关(r=0.802、0.669、0.745,P<0.01);糖尿病病程、糖化血红蛋白、低密度脂蛋白、Hcy、SAA、S100β是老年2型糖尿病患者颈动脉不稳定斑块的危险因素(OR=1.384、1.582、2.147、2.560、2.309、3.728,P<0.05);Hcy、SAA、S100β均可评估老年2型糖尿病患者颈动脉不稳定斑块,三项联合评估的效能优于单项评估(Z=2.217、1.995、1.986,P<0.05)。结论老年2型糖尿病患者血清Hcy、SAA、S100β水平与颈动脉斑块稳定性相关,三项联合评估颈动脉不稳定斑块的效能优于单项评估。

miRNA调控claudin-2表达对溃疡性结肠炎小鼠巨噬细胞极化的机制

目的探讨微小核糖核酸(MicroRNA,miRNA)通过封闭蛋白2(Recombinant,claudin-2)表达变化对溃疡性结肠炎小鼠的保护作用及对巨噬细胞极化的调控。方法选取BALB/c雌性小鼠按照体重随机分成对照组、模型组以及上调组和下调组,每组15只。对4组小鼠溃疡性结肠组织进行HE染色,观察分析小鼠溃疡性结肠炎评分情况、炎性因子、免疫细胞、巨噬细胞、claudin-2表达。结果与对照组比较,模型组、上调组、下调组miRNA表达升高(P<0.05);与模型组比较,上调组miRNA表达降低、下调组升高(P<0.05);与上调组比较,下调组miRNA表达升高(P<0.05);与模型组比较,上调miRNA第3 d、5 d、7 d的溃疡性结肠炎模型小鼠明显降低、下调组升高;与上调组比较,下调组miRNA表达升高(P<0.05);与对照组比较,模型组、上调组、下调组T淋巴细胞的糖蛋白(CD4^(+))、白细胞分化抗原(CD8^(+))水平升高(P<0.05);与模型组比较,上调组CD4^(+)、CD8^(+)水平降低,下调组升高(P<0.05);与上调组比较,下调组CD4^(+)、CD8^(+)水平升高(P<0.05);与对照组比较,模型组、上调组、下调组肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)水平升高(P<0.05);与模型组比较,上调组TNF-α、IL-6、IL-8水平降低(P<0.05);与上调组比较,下调组升高(P<0.05);与对照组比较,模型组、上调组、下调组诱导型一氧化氮合酶(iNOS)水平升高,巨噬细胞甘露糖受体(CD206)降低(P<0.05);与模型组比较,上调组iNOS水平降低、CD206水平升高,下调组iNOS水平升高、CD206水平降低(P<0.05);与上调组比较,下调组iNOS升高、CD206降低(P<0.05);与对照组比较,模型组、上调组、下调组claudin-2蛋白表达升高(P<0.05);与模型组比较,上调组claudin-2蛋白表达降低、下调组claudin-2蛋白表达升高(P<0.05)。结论上调溃疡性结肠炎小鼠miRNA能够调节巨噬细胞极化,从而改善溃疡性结肠炎小鼠。

低剂量CT结合SHOX2、RASSF1A甲基化在肺癌早期预警中的应用

目的探讨低剂量CT结合Ras相关区域家族蛋白1A(RASSF1A)、矮小同源盒基因2(SHOX2)甲基化在肺癌早期预测中的应用价值。方法选取2021年1月~2023年1月我院90例拟行肺结节手术患者,根据手术病理学分为肺良性结节组和肺癌组。2组均于术前行低剂量CT检查、SHOX2、RASSF1A甲基化检测,采用Kappa指数分析上述检查结果与手术病理学一致性,分析低剂量CT、SHOX2、RASSF1A甲基化与血清肿瘤标志物[癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCC-Ag)、细胞角蛋白19片段(CYFRA21)]对肺癌诊断效能,采用Spearman低剂量CT检查、SHOX2、RASSF1A甲基化与临床病理特征相关性。结果低剂量CT、SHOX2、RASSF1甲基化及三者联合分别确定40例、43例、46例、58例肺癌,三者联合与手术病理学诊断肺癌效能一致性Kappa值为0.951;三者联合诊断肺癌敏感度96.67%、准确度97.78%均高于三者单一诊断效能(P<0.05);肺癌患者血清CEA、SCC、NSE、CYFRA21水平均高于肺良性结节患者(P<0.05);低剂量CT联合SHOX2、RASSF1甲基化诊断肺癌效能的AUC为0.983,近似于四种血清肿瘤标志物诊断肺癌效能的AUC 0.933;不同肿瘤直径、临床分期、组织学分化肺癌患者低剂量CT检出率及SHOX2、RASSF1A甲基化阳性率比较差异有统计学意义(P<0.05);肺癌患者低剂量CT检出率、SHOX2及RASSF1A甲基化阳性率与肿瘤直径、临床分期呈正相关,与组织学分化呈负相关(P<0.05)。结论低剂量CT联合SHOX2及RASSF1A甲基化可用于肺癌早期预警中,临床可通过其进行早期诊断、评估病情进展程度,以针对性展开后续治疗,改善预后。

2型糖尿病血糖控制中二甲双胍联合门冬胰岛素治疗的作用价值

目的探究二甲双胍与门冬胰岛素联合治疗2型糖尿病(Diabetes Mellitus Type 2,T2DM)对血糖的控制效果。方法选取2021年6月—2023年6月吉林省人民医院收治的100例T2DM患者为研究对象,以投掷硬币法分为参照组(n=50,二甲双胍治疗)、观察组(n=50,二甲双胍与门冬胰岛素联合治疗)。比较两组临床治疗效果、不良反应总发生率、血糖控制情况及血清炎性因子水平。结果观察组治疗总有效率(96.00%)高于参照组(84.00%),差异有统计学意义(χ^(2)=4.000,P<0.05)。两组不良反应总发生率对比,差异无统计学意义(P>0.05)。与治疗前相比,两组治疗半年后血糖水平、白细胞介素-6、白细胞介素-12水平均降低、白细胞介素-10水平升高,且观察组上述指标优于参照组,差异有统计学意义(P均<0.05)。结论二甲双胍与门冬胰岛素联合治疗T2DM患者时可提高疗效,患者血糖控制情况更佳,血清炎性因子水平也得到明显改善,安全性较高。

梅毒血清固定患者中NOD样受体蛋白3和Toll样受体4表达与Th1/Th2相关细胞因子的相关性研究

目的探究梅毒血清固定患者中NOD样受体蛋白3(NLRP3)、Toll样受体4(TLR4)表达与辅助性T细胞1/辅助性T细胞2(Th1/Th2)相关细胞因子的相关性。方法选取2021年2月至2022年4月川北医学院附属三台医院收治的197例梅毒患者作为研究对象。将进行驱梅治疗后血清转阴者纳入转阴组(n=88),未进行驱梅治疗者纳入梅毒组(n=45),接受驱梅治疗后血清固定者纳入固定组(n=64)。另选取同期进行体检的健康人作为对照组(n=53)。采用实时荧光定量聚合酶链反应检测外周血单个核细胞(PBMCs)中NLRP3、TLR4 mRNA相对表达水平;采用酶联免疫吸附试验法检测Th1/Th2相关细胞因子的表达水平;采用Pearson法分析TLR4、NLRP3 mRNA与Th1/Th2相关细胞因子的相关性。结果各组PBMCs中TLR4、NLRP3 mRNA表达水平比较,梅毒组>转阴组>对照组>固定组,差异具有统计学意义(P<0.05);各组白介素(IL)-2、γ干扰素(IFN-γ)水平比较,对照组>转阴组>梅毒组>固定组,差异具有统计学意义(P<0.05);各组IL-1β、IL-4、IL-10及IL-18水平比较,对照组<转阴组<梅毒组<固定组,差异具有统计学意义(P<0.05);梅毒血清固定患者TLR4、NLRP3 mRNA表达与IFN-γ、IL-2呈正相关,与IL-1β、IL-4、IL-10、IL-18呈负相关(P<0.05)。结论梅毒血清固定患者NLRP3、TLR4 mRNA表达水平显著降低,且与Th1/Th2相关细胞因子密切相关。

2型糖尿病患者血清铁蛋白水平与体脂分布的相关性分析

目的探讨2型糖尿病(T2DM)患者血清铁蛋白水平与体脂分布的关系。方法收集2020年6-11月在兰州大学第一医院内分泌科住院的151例T2DM患者进行回顾性分析。所有患者根据血清铁蛋白水平分为高血清铁蛋白组(n=50)与正常血清铁蛋白组(n=101)。测量两组患者的血糖、血脂,以及内脏脂肪面积(VFA)、皮下脂肪面积(SFA)、肝脂肪、身高、体重和腰围(WC),计算体重指数(BMI)和内脏肥胖指数(VAI),并进行组间比较;采用Pearson或Spearman相关性分析及多元线性回归分析血清铁蛋白水平与体脂分布的相关性。结果高血清铁蛋白组VAI和WC均明显高于正常血清铁蛋白组[分别为3.13(2.16,4.58)vs.2.66(1.66,3.81),(96.66±7.78)cm vs.(91.96±9.75)cm,P<0.05]。高血清铁蛋白组中心性肥胖和血脂异常的患病率明显高于正常血清铁蛋白组(分别为88.0%vs.68.3%,90.0%vs.75.2%,P<0.05),且血糖控制差、胰岛素抵抗的构成比也高于正常血清铁蛋白组(分别为96.0%vs.78.2%、62.0%vs.40.6%,P<0.05),而两组间BMI、VFA、SFA水平,以及降糖药物使用情况和糖尿病慢性并发症差异无统计学意义(P>0.05)。T2DM患者血清铁蛋白水平与VAI、WC、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂异常、血清肌酐(SCr)呈正相关(r=0.171、0.207、0.187、0.243、0.270、0.162、0.162,P<0.05),与年龄、性别和糖尿病病程呈负相关(r=-0.191、-0.434、-0.352,P<0.05)。多元线性回归显示,在男性T2DM患者中,糖尿病病程和FPG是血清铁蛋白水平增高的危险因素,但WC及VAI对血清铁蛋白的影响不明显;而在女性T2DM患者中,糖尿病病程、TG和VAI是血清铁蛋白水平增高的危险因素(P<0.05)。结论女性T2DM患者的血脂紊乱和内脏脂肪增加是血清铁蛋白水平增高的危险因素。

Relationship between serum b2-microglobulin levels and virological breakthrough in HBeAg-negative chronic hepatitis B patients,under long-term treatment schedules including lamivudine

AIM: Predictive value of serum b2-microglobulin (b2m)levels for virological breakthrough (VB) in HBeAg-negative chronic hepatitis B (CHB) patients under long-term treatment schedules including lamivudine (LAM).METHODS: Serum b2m levels were calculated during treatment in 25 CHB patients under long-term LAM monotherapy (group A) and 12 patients under initial interferon plus LAM treatment followed by LAM monotherapy (group B), using the MEIA technology. We used Cox proportional hazard models in order to investigate the association between serum b2m levels and VB.RESULTS: Seven of 25 patients (28%), 9/25 (36%) and 14/25 (56%) from group A and 0/12, 2/12 (16.6%) and 3/12 (25%) from group B exhibited VB at months 12, 24 and 36 of treatment, respectively. All patients, from both groups, who did not show VB exhibited b2m elevation in mo 3. The duration of b2m elevation was significantly longer in the virological responder's subgroup from group A than the non-responder's one (7.3±2.6 vs 3.8±3.4 mo,P = 0.02). In comparison to group A patients whose b2m levels were increased at 3 mo, patients whose b2m levels were decreased had 4.6 times higher risk of experiencing VB (RR = 4.6, P = 0.024). When baseline variables were simultaneously included in the same Cox model, decreased b2m status was still associated with increased risk of VB (RR = 12.2, P = 0.03).CONCLUSION: In HBeAg-negative CHB patients under either long-term LAM monotherapy or initial combination treatment, serum b2m levels at 3 mo of treatment,compared to baseline ones, might be a predictor of risk for VB.

2型糖尿病患者血清铁蛋白水平与血尿酸的关系

目的探究2型糖尿病(T2DM)患者血清铁蛋白(SF)水平与血尿酸(SUA)的关系,为临床上T2DM合并高尿酸血症(HUA)患者的诊治提供新的分子标志物。方法选取2021年8月至2022年9月于兰州大学第一医院内分泌科住院治疗的T2DM患者351例,根据SF的四分位数水平将其分为4组:Q1组(SF<76.2 ng/mL,87例)、Q2组(SF为76.2~138.9 ng/mL,88例)、Q3组(SF为139.0~240.9 ng/mL,87例)、Q4组(SF≥241.0 ng/mL,89例),比较不同SF水平组患者SUA水平、HUA患病率的差异。根据是否合并HUA将T2DM患者分为HUA组(54例)和非HUA组(297例),比较两组之间SF水平及高铁蛋白血症患病率的差异。采用Pearson相关、Spearman秩相关及多元线性回归模型分析T2DM患者SF与SUA之间的相关性,采用二元logistic回归模型分析T2DM患者HUA发生的影响因素。结果T2DM患者Q4组SUA水平[(344.54±105.94)μmol/L]高于Q1组[(308.34±79.60)μmol/L,P<0.05],不同SF水平组间HUA患病率差异无统计学意义(P>0.05)。HUA组SF水平[174.50(105.40,295.25)ng/mL]高于非HUA组[129.00(69.55,226.00)ng/mL],差异有统计学意义(P<0.05);HUA组患者高铁蛋白血症的患病率(18.52%,10/54)与非HUA组(17.17%,51/297)比较差异无统计学意义(P>0.05)。相关性分析提示SUA与SF呈正相关(rs=0.110,P=0.040)。多元线性回归分析提示T2DM患者SF与SUA呈独立正相关(P<0.05)。二元logistic回归分析提示T2DM患者SF与HUA呈独立正相关(OR=1.003,P=0.023)。结论T2DM患者SF水平与SUA密切相关,SF是T2DM患者HUA发生的独立影响因素。

Correlation between Serum CD36 Level and Lipid Profile in Patients with Type 2 Diabetes Mellitus, Khartoum State, Sudan

Background: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia. DM-related dyslipidemia are associated with complications resulting from progressive damage of various organs. CD36 is 88-kD, class B scavenger receptor, expressed on different types of cells. In diabetic patients, LDL particles are glycated with strong level;this increases CD36 expression, initiates foam cell formation and accelerates atherosclerosis. Objective: This study aimed to determine the correlation between serum CD36 level and lipid profile among patients with type 2 diabetes mellitus in Zeenam Specialized center, Khartoum State, Sudan, in a period between 2019 and 2022. Methodology: Hundred participants at different ages were included in this study;70 were type 2 diabetic patients (cases) and 30 apparently healthy individual (control). 3 ml of venous blood were collected from the participants by using a sterile needle and syringe into a labeled plain container. Each sample was stood until complete clot occurs. Clotted blood sample was then centrifuged to obtain the serum. Then they were used for measurement of total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride and soluble CD36 levels. Total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides were measured using Biosystem chemistry analyzer BTS-302. Serum CD36 was measured using Microplate Reader (URIT-660). Results: The results revealed that serum total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels were significantly higher in patients with type 2 diabetes mellitus compared with control (P = 0.03, P = 0.031, P = 0.000, P = 0.000) respectively, while there is no statistically significant differences in serum CD36 level between cases and control (P = 0.129). Also this study showed that there is no statistically significant correlation between serum CD36 level and total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, age and body mass index. Conclusion: This study concluded that there is no statistically significant difference in serum CD36 level between cases and control. And sCD36 level was not correlated with total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, body mass index, and age.

β2-微球蛋白与血肌酐/血红蛋白比值联合检验结果在糖尿病早期肾损伤诊断中的应用价值

目的分析β2-微球蛋白(β2-microglobulin,β2-MG)与血肌酐/血红蛋白比值联合检验诊断糖尿病早期肾损伤的价值。方法选取2022年7月—2024年1月泰兴市中医院收治的82例糖尿病患者为研究对象,其中60例为单纯糖尿病患者,22例为糖尿病早期肾损伤患者,所有患者进行β2-MG、血肌酐/血红蛋白比值检测,对比不同检查方法的诊断价值(准确度、灵敏度、特异度)。结果β2-MG联合血肌酐/血红蛋白比值检测的灵敏度、准确度高于β2-MG、血肌酐/血红蛋白比值单独检测,差异有统计学意义(P均<0.05)。β2-MG与血肌酐/血红蛋白比值检测的灵敏度、特异度、准确度对比,差异无统计学意义(P均>0.05)。结论β2-MG与血肌酐/血红蛋白比值联合检验诊断糖尿病早期肾损伤的灵敏度、准确度均高于单一β2-MG、血肌酐/血红蛋白比值检测。

2型糖尿病患者血清胰岛素样生长因子-1水平与颈动脉不稳定性斑块的相关性

目的:分析2型糖尿病患者血清胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)水平与颈动脉不稳定性斑块的相关性。方法:选取孝感市中心医院内分泌科2022年2月至2023年2月住院治疗的2型糖尿病患者213例,使用彩色多普勒超声诊断仪测定双侧颈总动脉、分叉及颈内动脉、颈外动脉的内壁,根据超声影像特征将研究对象分为无斑块组(73例)、稳定性斑块组(51例)、不稳定性斑块组(89例)。检测并比较各组临床资料、实验室指标及血清IGF-1水平;采用Spearman相关分析探讨2型糖尿病患者合并颈动脉不稳定斑块组血清IGF-1水平与各指标的关系;采用多因素Logistic回归分析2型糖尿病患者颈动脉斑块不稳定的影响因素。结果:与无斑块组比较,稳定性斑块组年龄、收缩压、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平较高,IGF-1水平较低;不稳定斑块组年龄、HbA1c、TG、LDL-C水平较高,IGF-1水平较低,差异均有统计学意义(P<0.05)。与稳定性斑块组比较,不稳定性斑块组HbA1c、TG、LDL-C水平较高,收缩压、IGF-1水平较低,差异有统计学意义(P<0.05)。Spearman相关分析显示,2型糖尿病合并颈动脉不稳定斑块组患者血清IGF-1水平与年龄、收缩压、HbA1c、LDL-C呈负相关(P<0.05)。Logistic回归分析显示,血清HbA1c、LDL-C、TG、IGF-1为2型糖尿病患者颈动脉斑块不稳定的影响因素(P<0.05)。结论:IGF-1低水平可能为2型糖尿病患者颈动脉斑块不稳定的影响因素,可辅助评估斑块的形成及进展。

Serum neuronal pentraxin 2 is related to cognitive dysfunction and electroencephalogram slow wave/fast wave frequency ratio in epilepsy

BACKGROUND Cognitive dysfunction in epileptic patients is a high-incidence complication.Its mechanism is related to nervous system damage during seizures,but there is no effective diagnostic biomarker.Neuronal pentraxin 2(NPTX2)is thought to play a vital role in neurotransmission and the maintenance of synaptic plasticity.This study explored how serum NPTX2 and electroencephalogram(EEG)slow wave/fast wave frequency ratio relate to cognitive dysfunction in patients with epilepsy.AIM To determine if serum NPTX2 could serve as a potential biomarker for diagnosing cognitive impairment in epilepsy patients.METHODS The participants of this study,conducted from January 2020 to December 2021,comprised 74 epilepsy patients with normal cognitive function(normal group),37 epilepsy patients with cognitive dysfunction[epilepsy patients with cognitive dysfunction(ECD)group]and 30 healthy people(control group).The minimental state examination(MMSE)scale was used to evaluate cognitive function.We determined serum NPTX2 levels using an enzyme-linked immunosorbent kit and calculated the signal value of EEG regions according to the EEG recording.Pearson correlation coefficient was used to analyze the correlation between serum NPTX2 and the MMSE score.RESULTS The serum NPTX2 level in the control group,normal group and ECD group were 240.00±35.06 pg/mL,235.80±38.01 pg/mL and 193.80±42.72 pg/mL,respectively.The MMSE score was lowest in the ECD group among the three,while no significant difference was observed between the control and normal groups.In epilepsy patients with cognitive dysfunction,NPTX2 level had a positive correlation with the MMSE score(r=0.367,P=0.0253)and a negative correlation with epilepsy duration(r=−0.443,P=0.0061)and the EEG slow wave/fast wave frequency ratio value in the temporal region(r=−0.339,P=0.039).CONCLUSION Serum NPTX2 was found to be related to cognitive dysfunction and the EEG slow wave/fast wave frequency ratio in patients with epilepsy.It is thus a potential biomarker for the diagnosis of cognitive impairment in patients with epilepsy.