血清γ-氨基丁酸、胰岛素样生长因子-1对老年糖尿病前期病人心血管事件风险的交互作用分析

doi:10.3969/j.issn.1003-9198.2024.08.014

摘要/Abstract

摘要： 目的探讨γ-氨基丁酸(GABA)、胰岛素样生长因子-1(IGF-1)对老年糖尿病前期病人心血管事件风险的交互作用。方法选取2020年1月至2023年1月在我院诊治的100例老年糖尿病前期病人为对照组,选取同期100例糖尿病前期并发心血管事件病人为观察组。2组均进行血清GABA、IGF-1水平检测。采用二元Logistic模型分析糖尿病前期病人心血管事件发生的影响因素。采用样条函数与Logistic回归结合的限制性立方样条法分析GABA、IGF-1与糖尿病前期病人心血管事件关联强度。采用相对超危险度比(RERI)、归因比(AP)、交互作用指数(S)评价GABA与IGF-1对糖尿病前期病人心血管事件的交互作用。结果观察组年龄、SBP、FPG、餐后2 h血糖(2hPG)、TC、TG、LDL-C高于对照组,HDL-C、GABA、IGF-1水平低于对照组(P＜0.05)。二元Logistic回归分析显示,SBP、FPG、LDL-C是糖尿病前期病人心血管事件的危险因素,GABA、IGF-1是保护因素(P＜0.05)。GABA、IGF-1与心血管事件关联强度呈负相关,当GABA＞5.00 μmol/L、IGF-1＞119 ng/mL时糖尿病前期病人心血管事件风险最低;以GABA、IGF-1同时高表达时为共同参照,调整年龄、SBP、FPG、TC、TG、LDL-C、HDL-C后,GABA与IGF-1低表达对糖尿病前期病人心血管事件的发生存在正向交互作用,协同效应为二者单独存在产生效应之和的2.760倍(S=2.760),在糖尿病前期心血管事件发生风险中有60.43%(API=60.43%)是由GABA与IGF-1低表达交互作用引起的。结论 GABA、IGF-1是糖尿病前期病人心血管事件的独立保护因素,两者在糖尿病前期病人心血管事件的发生中具有协同作用,当病人GABA、IGF-1表达均降低时应警惕心血管事件发生风险。

关键词: 老年人, 糖尿病前期, γ-氨基丁酸, 胰岛素样生长因子-1, 心血管事件

Abstract: Objective To explore the interaction effects of serum levels of γ-aminobutyric acid(GABA) and insulin-like growth factor-1(IGF-1) on cardiovascular event risk in the elderly patients with prediabetes. Methods A total of 100 patients with prediabetes in our hospital from January 2020 to January 2023 were selected as the control group, and 100 patients with prediabetes complicated with cardiovascular events during the same period were selected as the observation group. The serum levels of GABA and IGF-1 in the two groups were detected. Binary Logistic model was used to analyze the influencing factors of cardiovascular events in the elderly patients with prediabetes. The restricted cubic spline method was used to analyze the intensity of association between GABA, IGF-1 and cardiovascular events in the elderly patients with prediabetes. The interaction of GABA and IGF-1 on cardiovascular events in prediabetic patients was analyzed by relative excess risk due to interaction (RERI), attributable proportion to the interaction (AP) and synergy index (S). Results Age, the levels of systolic blood pressure (SBP), fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2hPG), total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were significantly higher and the levels of high-density lipoprotein cholesterol (HDL-C), GABA and IGF-1 were lower in the observation group than those in the control group (P<0.05). Binary Logistic regression analysis showed that SBP, FPG and LDL-C were the risk factors, while GABA and IGF-1 were the protective factors for cardiovascular events in the elderly patients with prediabetes (P<0.05).The continuous changes of GABA and IGF-1 were negatively correlated with the strength of association of cardiovascular events, and the risk of cardiovascular events in prediabetic patients was lowest when the level of GABA was > 5.00 μmol/L and the level of IGF-1 was >119 ng/mL. Both high expression of GABA and IGF-1 were as common reference, and after adjusting age, SBP, FPG, TC, TG, LDL-C and HDL-C, low expression of GABA and IGF-1 had a positive interaction on the occurrence of cardiovascular events in prediabetic patients. The synergistic effect was 2.760 times of the summation of the effects of GABA and IGF-1 alone (S=2.760). In the total risk of cardiovascular events in prediabetic individuals, the interaction of low expression of GABA and IGF-1 accounted for 60.43% (API=60.43%). Conclusions GABA and IGF-1 are independent protective factors of cardiovascular events in the patients with prediabetes, and they play a synergistic role in the occurrence of cardiovascular events in the elderly patients with prediabetes. When the expression of GABA and IGF-1 is reduced, the risk of cardiovascular events should be considered.

Key words: aged, prediabetes, gamma-aminobutyric acid, insulin-like growth factor-1, cardiovascular event

中图分类号:

R587.1

赵玉玲, 黄婧, 叶文春. 血清γ-氨基丁酸、胰岛素样生长因子-1对老年糖尿病前期病人心血管事件风险的交互作用分析[J]. 实用老年医学, 2024, 38(8): 816-820.

ZHAO Yuling, HUANG Jing, YE Wenchun. Interaction effects of serum levels of γ-aminobutyric acid and insulin-like growth factor-1 on cardiovascular event risk in elderly patients with prediabetes[J]. Practical Geriatrics, 2024, 38(8): 816-820.

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