Magnetic resonance imaging combined with serum endolipin and galactagoglobin-3 to diagnose cerebral infarction in the elderly with diabetes mellitus

BACKGROUND Magnetic resonance imaging(MRI)combined with serum endothelin and galactagoglobin-3(Gal-3)can improve the clinical diagnosis of diabetes mellitus complicated with cerebral infarction.AIM To analyze the clinical value of MRI combined with serum endolipin and Gal-3 for the diagnosis of cerebral infarction in the elderly with diabetes mellitus.METHODS One hundred and fifty patients with acute cerebral infarction hospitalized between January 2021 and December 2023 were divided into two groups according to comorbid diabetes mellitus,including 62 and 88 cases in the diabetic and nondiabetic cerebral infarction groups.Serum samples were collected to detect the expression of serum endolipoxins,and Gal-3,and cranial MRI was performed at admission.Differences between the two groups were compared to analyze the diagnostic value of these parameters.RESULTS Serum endolipin and Gal-3 expression were higher in the diabetic cerebral infarction group(P<0.05).The arterial wall area,vessel area,normalized wall index,and lumen stenosis rate were higher in the diabetic cerebral infarction group,while the rate of arterial lumen moderate and severe stenosis was 48.39% higher(36.36%,P<0.05).The percentage of large(29.03%)and multiple infarcts(33.87%)in the diabetic cerebral infarction group was higher(13.64% and 20.45%),and the incidence rate of lacunar infarcts was lower(37.10%vs 65.91%)(P<0.05).The total incidence of arterial plaque in patients in the diabetic cerebral infarction group was 96.77% higher(69.32%),while the incidence of necrotic lipid core plaque was 58.06%higher(26.14%)(P<0.05).Receiver operating characteristic curve analysis was performed to assess the diagnosis utility of these techniques.MRI in combination with serum endoglin and Gal-3 had the highest area under the curve,the Yoden index,sensitivity and specificity(P<0.05).CONCLUSION The expression of serum endolipin and Gal-3 in elderly patients with diabetes mellitus with cerebral infarction showed an elevated trend,and the degree of luminal stenosis was severe.MRI predominantly revealed large and multiple infarct foci.This combined index examination can improve the clinical diagnosis of diabetes mellitus combined with cerebral infarction.

血清丝氨酸蛋白酶抑制剂、内脂素、趋化素在2型糖尿病并发非酒精性脂肪性肝病中的表达及与胰岛素抵抗的关系

目的探讨血清丝氨酸蛋白酶抑制剂(Vaspin)、内脂素(Visfatin)、趋化素(Chemerin)在2型糖尿病(T2DM)并发非酒精性脂肪性肝病(NAFLD)病人中的表达及其与胰岛素抵抗(IR)的关系。方法选取2018年1月至2019年8月南阳市中心医院收治的T2DM,并发NAFLD病人76例作为观察组,未并发NAFLD病人62例作为对照组。比较两组血清Vaspin、Visfatin、Chemerin水平,受试者工作特征(ROC)曲线分析上述因子对T2DM并发NAFLD的诊断价值,并结合肝影像学诊断结果对比不同病情程度病人血清Vaspin、Visfatin、Chemerin水平、胰岛素参数[胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)],分析各血清因子与胰岛素参数关联性及T2DM并发NAFLD病情程度的影响或关联作用因素。结果观察组血清Vaspin[(82.03±12.46)ng/L比(70.81±11.22)ng/L]、Visfatin[(39.58±6.90)µg/mL比(33.27±5.73)µg/mL]、Chemerin[(53.37±8.61)ng/L比(45.39±8.02)ng/L]水平及HOMA-IR[(2.71±0.67)比(1.36±0.54)]高于对照组(P<0.05);Chemerin诊断T2DM并发NAFLD的AUC值最大,为0.758。随T2DM并发NAFLD病情加重血清Vaspin、Visfatin、Chemerin、HOMA-IR呈升高趋势,ISI呈降低趋势(P<0.05)。血清Vaspin、Visfatin、Chemerin与HOMA-IR呈正相关,与ISI呈负相关(P<0.05)。BMI、WHR、血清Vaspin、Visfatin、Chemerin、HOMAIR、ISI是T2DM并发NAFLD病情程度的独立影响或关联作用因素(P<0.05)。结论T2DM并发NAFLD病人存在血清Vaspin、Visfatin、Chemerin异常表达情况,且表达水平与IR关系密切,可能通过诱导IR间接参与T2DM并发NAFLD的发病发展过程。

Roux-en-Y胃旁路手术对2型糖尿病患者糖脂代谢、胰岛功能及内脂素水平变化影响及疗效相关因素分析

[目的]探究Roux-en-Y胃旁路手术对2型糖尿病(T2 DM)患者糖脂代谢、胰岛功能及内脂素水平变化影响及疗效相关因素。[方法]回顾性分析接受腹腔镜下Roux-en-Y胃旁路手术治疗的87例T2 DM患者临床资料,收集患者术前和术后3、6、12个月糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2hFG)、糖化血红蛋白(HbA1 c)、空腹C肽(FCP)]、脂代谢指标[三酰甘油(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)]、胰岛功能指标[稳态模型β细胞功能指数(HOMA-β)、稳态模型胰岛素(Ins)抵抗指数(HOMA-IR)、稳态模型Ins敏感指数(HOMA-IS)、早相Ins30分泌(ΔIns_(30)/ΔC_(30))、晚相Ins120分泌(ΔIns_(120)/ΔC_(120))]及内脂素水平变化。根据患者术后康复情况,参照疗效标准将患者分为治愈组(55例)和非治愈组(32例)。[结果]术后3、6、12个月FPG、2hFG、HbA1 c、FCP水平均较术前降低,差异有统计学意义(P<0.05)。术后3、6、12个月TC、TG水平均较术前降低,术后12个月HDL水平高于术前,术后12个月LDL水平低于术前,差异均有统计学意义(P<0.05)。术后3、6、12个月HOMA-IRa低于术前,术后6、12个月ΔIns_(30)/ΔC_(30) a高于术前,术后3个月、6个月ΔIns_(120)/ΔC_(120) a高于术前,差异有统计学意义(P<0.05)。术后3、6、12个月内脂素水平均较术前降低,差异有统计学意义(P<0.05)。术前资料显示:治愈者年龄、病程低于非治愈组,BMI、2hFG、FCP水平高于非治愈组(P<0.05)。多因素回归分析显示,年龄大、病程长、BMI水平低、FCP水平低是非治愈的独立危险因素(P<0.05)。[结论]T2 DM患者腹腔镜下Roux-en-Y胃旁路手术可显著改善糖脂代谢和胰岛功能,降低内脂素水平,且年龄大、病程长、BMI水平低、FCP水平低是非治愈的独立危险因素。