血清淀粉样蛋白A、C1q/肿瘤坏死因子相关蛋白9水平预测老年2型糖尿病病人心血管不良事件的价值

doi:10.3969/j.issn.1003-9198.2022.06.007

摘要/Abstract

摘要： 目的探讨血清淀粉样蛋白A(SAA)、C1q/肿瘤坏死因子相关蛋白(CTRP)9对老年T2DM病人心血管不良事件的预测价值。方法选取2016年4月至2019年4月在本院进行血糖控制管理的110例老年T2DM病人为研究对象。所有病人均定期随访2年,观察并记录病人随访期间心血管不良事件(急性冠脉综合征、心律失常、急性心力衰竭等)发生情况,比较发生组和未发生组入院时基本资料、实验室指标及血清SAA、CTRP9水平;采用多元Logistic回归分析老年T2DM病人心血管不良事件发生的危险因素;绘制ROC曲线分析血清SAA、CTRP9单独及联合预测老年T2DM病人心血管不良事件发生风险的价值;采用Spearman相关系数描述SAA与CTRP9的相关性。结果 110例老年T2DM病人中,31例发生心血管不良事件,发生率为28.18%。发生组病人入院时血清SAA水平高于未发生组,CTRP9水平低于未发生组,差异均有统计学意义(P＜0.01)。多元Logistic回归分析结果显示,入院时血清SAA高表达、CTRP9低表达是老年T2DM病人心血管不良事件发生的危险因素。ROC曲线分析结果显示,血清SAA、CTRP9单独及联合预测T2DM病人心血管不良事件发生风险的AUC分别为:0.842、0.815、0.883。Spearman相关分析显示,血清SAA与CTRP9呈负相关(r=-0.316,P=0.001)。结论入院时血清SAA、CTRP9水平对老年T2DM病人心血管不良事件发生风险具有一定预测价值,且二者联合预测价值最高。

关键词: 老年人, 2型糖尿病, 淀粉样蛋白A, C1q/肿瘤坏死因子相关蛋白9, 心血管不良事件

Abstract: Objective To investigate the predictive value of the serum levels of amyloid A (SAA) and C1q/tumor necrosis factor associated protein (CTRP) 9 for cardiovascular adverse events in the elderly patients with type 2 diabetes mellitus(T2DM). Methods A total of 110 elderly T2DM patients who received blood glucose control and management in our hospital from April 2016 to April 2019 were selected as the research subjects. All the patients were followed up regularly for 2 years, and the occurrence of adverse cardiovascular events (acute coronary syndrome, arrhythmia, acute heart failure, etc.) was recorded. All patients were divided into the occurrence group and the non-occurrence group. The basic data, laboratory indexes and serum levels of SAA and CTRP9 at admission were compared between the two groups. The risk factors of cardiovascular adverse events in the patients were analyzed by multiple Logistic regression; The receiver operating characteristic (ROC) curve was drawn to analyze the value of serum SAA and CTRP9 alone and combined in predicting the risk of cardiovascular adverse events in the patients; The correlation between SAA and CTRP9 was described by Spearman correlation coefficient. Results Among 110 elderly patients with T2DM, 31 cases had cardiovascular adverse events, with an incidence rate of 28.18%. Compared with the non-occurrence group, the level of SAA was higher, and the level of CTRP9 was lower in the occurrence group, with statistically significant differences (P<0.01). Multivariate Logistic regression analysis showed that the high expression of SAA and the low expression of CTRP9 at admission were risk factors for the occurrence of cardiovascular adverse events in the elderly T2DM patients. ROC curve analysis showed that the area under curve of serum SAA and CTRP9 alone and in combination to predict the risk of cardiovascular adverse events in the elderly T2DM patients was 0.842, 0.815, 0.883, respectively. Spearman correlation analysis showed that there was a negative correlation between SAA and CTRP9 (r=-0.316, P=0.001). Conclusions The serum levels of SAA and CTRP9 at admission have certain predictive value for the incidence of cardiovascular adverse events in the elderly patients with T2DM, and the predictive value of their combination is the highest.

Key words: aged, type 2 diabetes mellitus, amyloid A, C1q/tumor necrosis factor related protein 9, cardiovascular adverse events

中图分类号:

R 587.1

李白均, 罗华福, 王晓书, 魏倩. 血清淀粉样蛋白A、C1q/肿瘤坏死因子相关蛋白9水平预测老年2型糖尿病病人心血管不良事件的价值[J]. 实用老年医学, 2022, 36(6): 575-579.

LI Bai-jun, LUO Hua-fu, WANG Xiao-shu, WEI Qian. Value of serum levels of amyloid A and C1q/tumor necrosis factor related protein 9 in predicting cardiovascular adverse events in elderly patients with type 2 diabetes mellitus[J]. Practical Geriatrics, 2022, 36(6): 575-579.

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