[1]谢 瑞a,薛开成a,赵志先b,等.亚临床型糖尿病心肌病患者血清GSN 水平检测及临床诊断价值研究[J].现代检验医学杂志,2023,38(04):83-88.[doi:10.3969/j.issn.1671-7414.2023.04.015]
　XIE Ruia,XUE Kaichenga,ZHAO Zhixianb,et al.Study on the Detection of Serum GSN Level and Its Clinical Diagnostic Value in Subclinical Diabetes Cardiomyopathy[J].Journal of Modern Laboratory Medicine,2023,38(04):83-88.[doi:10.3969/j.issn.1671-7414.2023.04.015]
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亚临床型糖尿病心肌病患者血清GSN 水平检测及临床诊断价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年04期
页码:
83-88
栏目:
论著
出版日期:
2023-07-15

文章信息/Info

Title:
Study on the Detection of Serum GSN Level and Its Clinical Diagnostic Value in Subclinical Diabetes Cardiomyopathy
文章编号:
1671-7414（2023）04-083-06
作者:
谢 瑞a; 薛开成a; 赵志先b; 汤万春a
（内蒙古科技大学包头医学院第二附属医院a. 心血管内科；b. 超声科, 内蒙古包头 014030）
Author(s):
XIE Ruia;  XUE Kaichenga;  ZHAO Zhixianb;  TANG Wanchuna
（a. Department of Cardiovascular Medicine；b. Department of Ultrasound, the Second Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology，Inner Mongolia Baotou 014030, China）
关键词:
亚临床型; 糖尿病心肌病; 凝溶胶蛋白前体
分类号:
R587.2；R446.11
DOI:
10.3969/j.issn.1671-7414.2023.04.015
文献标志码:
A
摘要:
目的　研究血清凝溶胶蛋白前体(gelsolin，GSN) 对亚临床型糖尿病心肌病(diabetic cardiomyopathy，DCM) 的诊断价值。方法　选取2019 年1 月～ 2021 年1 月期间内蒙古科技大学包头医学院第二附属医院诊治的102 例无心血管症状的2 型糖尿病患者为研究对象，根据是否存在DCM分为亚临床型DCM组（n=48）和无心功能不全的对照组（n=54），收集所有研究对象一般临床资料及超声心动检查结果。应用酶联免疫吸附实验检测所有研究对象血清GSN 水平。多因素Logistic 回归分析影响亚临床型DCM 的因素。受试者工作特征曲线分析糖尿病病程、HbA1c，血清GSN 及联合检测对亚临床型DCM 的诊断价值。结果　亚临床型DCM 组血清GSN 水平（133.43±10.27mg/L vs 63.43±5.25mg/L）、年龄、糖尿病病程、总胆固醇、三酰甘油、低密度脂蛋白- 胆固醇、糖化血红蛋白、E 值、A 值和左心房容积指数高于对照组(t/χ2=2.022 ～ 44.047, 均P <0.05)，而二尖瓣环e’ 波速度、室间隔e’ 波速度和E/A 比值低于对照组(t=3.617~6.675,均P <0.05)，差异具有统计学意义。血清GSN 水平与亚临床型DCM 患者室间隔e' 波速度、二尖瓣环e’ 波速度和E/A比值呈显著负相关（r=-0795 ～ -0.650，均P <0.05），与A 值、左心房容积指数呈显著正相关（r=0.713，0.740，均P<0.05）。血清GSN（OR=1.415，95%CI: 1.116~1.793），糖尿病病程（OR=1.513，95%CI: 1.25~2.034）和HbA1c（OR=1.294，95%CI: 1.087~1.541）是影响亚临床型DCM 发生的独立因素( 均P<0.05)。糖尿病病程、HbA1c，血清GSN 三者联合检测对亚临床型DCM 诊断的曲线下面积（95%CI）为0.911(0.869 ～ 0.941)，显著优于单一指标检测0.872(0.805 ～ 0.916)，0.793(0.727 ～ 0.843) 和0847 (0.805 ～ 0.921) (Z=3.786，4.769，4.027，P =0.012，0.000，0.002)。结论　亚临床型DCM患者血清GSN 水平升高，是新的亚临床型DCM 的生物标志物，糖尿病病程、HbA1c 与血清GSN 联合对亚临床型DCM 具有较高的诊断价值。
Abstract:
Objective　To study the diagnostic value of serum gelsolin (GSN) in subclinical diabetic cardiomyopathy (DCM). Methods　102 patients with type 2 diabetes mellitus (T2DM) without cardiovascular symptoms diagnosed and treated in the Second Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology from January 2019 to January 2021 were selected as the study objects. They were divided into subclinical DCM group (n=48) and control group (n=54) without cardiac insufficiency according to whether there was DCM. The general clinical data and echocardiography results of all subjects were collected. The serum GSN levels of all subjects were detected by ELISA. Multivariate logistic regression analysis was used to analyze the factors influencing subclinical DCM. The diagnostic value of the course of diabetes, HbA1c, serum GSN and their combined detection in subclinical DCM was analyzed by ROC curve. Results　The serum GSN level (133.43 ± 10.27mg/L vs 63.43 ± 5.25mg/L), age, duration of diabetes, total cholesterol, triglycerides, low-density lipoprotein cholesterol, glycosylated hemoglobin, E value, A value, and left atrial volume index in the subclinical DCM group were higher than those in the control group(t/χ2=2.022 ～ 44.047, all P <0.05), while the mitral annulus e’wave velocity, interventricular septum e’ wave velocity, and E/A ratio were lower than those in the control group(t=3.617~6.675, all P<0.05),with statistically significant differences. Serum GSN level was negatively correlated with ventricular septal e’wave velocity, mitral annular e’ wave velocity and E/A ratio (r=-0.795 ～ -0.650, all P<0.05), and positively correlated with A value and left atrial volume index (r=0.713, 0.740, P<0.05) in patients with subclinical DCM. Serum GSN (OR=1.415, 95%CI: 1.116~1.793), course of diabetes (OR=1.513, 95%CI: 1.125~2.034) and HbA1c (OR=1.294，95%CI: 1.087~1.541) were independent factors influencing subclinical DCM(all P<0.05). The area under the curve (95% CI) of the combined detection of diabetes duration， HbA1c，and serum GSN for the diagnosis of subclinical DCM was 0.911 (0.869 ～ 0.941), which was significantly higher than the single indicator detection of 0.872 (0.805 ～ 0.916), 0.793 (0.727 ～ 0.843) and 0847 (0.805 ～ 0.921) (Z=3.786, 4.769, 4.027, P=0.012, 0.000，0.002).Conclusion　The level of serum GSN in patients with subclinical DCM was increased, which is a new biomarker of subclinical DCM. The combination of diabetes duration, HbA1c and serum GSN has high diagnostic value for subclinical DCM.

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备注/Memo

备注/Memo:
基金项目：内蒙古自治区自然科学基金项目（2018MS08140)：细胞凋亡信号通路参与调控糖尿病心肌病的病理机制。
作者简介：谢瑞（1981-），男，硕士，副主任医师，主要从事心血管病治疗及研究，E-mail：xieruift030@163.com。
通讯作者：汤万春（1981-）, 男，硕士，副主任医师，主要从事心血管病治疗及研究，E-mail：1057779631@qq.com。
更新日期/Last Update: 2023-07-15