[1]徐珍望,刘 佳.高频超声与血清VEGF 和bFGF 水平检测联合对糖尿病患者肌肉减少症的诊断价值分析[J].现代检验医学杂志,2022,37(04):75-80.[doi:10.3969/j.issn.1671-7414.2022.04.015]
　XU Zhen-wang,LIU Jia.Diagnostic Value of High Frequency Ultrasound Combined with Serum VEGF and bFGF Levels in Diabetic Patients with Sarcopenia[J].Journal of Modern Laboratory Medicine,2022,37(04):75-80.[doi:10.3969/j.issn.1671-7414.2022.04.015]
点击复制

高频超声与血清VEGF 和bFGF 水平检测联合对糖尿病患者肌肉减少症的诊断价值分析()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年04期
页码:
75-80
栏目:
论著
出版日期:
2022-07-15

文章信息/Info

Title:
Diagnostic Value of High Frequency Ultrasound Combined with Serum VEGF and bFGF Levels in Diabetic Patients with Sarcopenia
文章编号:
1671-7414（2022）04-075-06
作者:
徐珍望; 刘 佳
鄂东医疗集团黄石市中心医院超声影像科, 湖北黄石 435000
Author(s):
XU Zhen-wang; LIU Jia
Department of Ultrasound Imaging, Huangshi Central Hospital, Edong Healthcare, Hubei Huangshi 435000, China
关键词:
高频超声; 血管内皮生长因子; 碱性成纤维细胞生长因子; 糖尿病肌肉减少症
分类号:
R587.2；R392.11
DOI:
10.3969/j.issn.1671-7414.2022.04.015
文献标志码:
A
摘要:
目的 探讨高频超声联合血清血管内皮生长因子（vascular endothelial growth factor，VEGF）、碱性成纤维细胞生长因子（basic fibroblast growth factor, bFGF）诊断糖尿病肌肉减少症的价值。方法 选择2018 年6 月～ 2019 年12月鄂东医疗集团黄石市妇幼保健院收治的103 例T2DM 并发肌肉减少症患者（观察组）和100 例门诊体检健康志愿者（对照组）。根据肌肉减少症分期将观察组分为肌肉减少症前期（简称前期，38 例）、肌肉减少症期（简称减少期，34 例）和重度肌肉减少症期（简称重度期，31 例）。高频超声测量尺骨前肌、股外侧肌厚度和质量，应用酶联免疫吸附试验检测血清VEGF和bFGF 水平。Pearson 相关性分析尺骨前肌、股外侧肌质量、VEGF和bFGF 与四肢骨骼肌质量指数（relativeappendicular skeletal muscle mass，RASM）、握力和步速相关性。受试者工作特征曲线（receiver operating characteristiccurve，ROC）分析尺骨前肌、股外侧肌质量、VEGF 和bFGF 诊断T2DM 患者肌肉减少症的价值。结果 观察组尺骨前肌质量（14.32±3.59）、股外侧肌质量（21.01±3.89）、血清VEGF（185.24±20.13 ng/L）和bFGF（11.35±4.52 ng/L）水平均低于对照组（17.45±4.13，25.12±4.25， 236.42±36.49 ng/L，17.64±6.95 ng/L）， 差异有统计学意义（t=5.768 ～ 12.557，均P ＜ 0.001）。重度期、减少期患者尺骨前肌质量（11.25±0.42，14.35±2.51）、股外侧肌质量（18.46±0.61，21.34±3.26）、血清VEGF（171.25±3.65 ng/L，178.25±10.43 ng/L） 和bFGF（7.42±0.54 ng/L，12.05±2.17 ng/L）水平均低于前期组（16.80±1.03, 22.80±1.25，202.91±2.65ng/L, 13.93±1.77 ng/L), 差异有统计学意义（t=2.560 ～ 41.695，均P ＜ 0.001）。重度期尺骨前肌质量、股外侧肌质量、血清VEGF 和bFGF 水平低于减少期，差异有统计学意义（t=3.542 ～ 11.551，均P ＜ 0.001）。血清VEGF 和bFGF 水平与尺骨前肌质量、股外侧肌质量、RASM，握力和步速呈正相关（r=0.402 ～ 0.698，均P ＜ 0.05），尺骨前肌质量、股外侧肌质量与RASM，握力和步速呈正相关（r=0.369 ～ 0.719，均P ＜ 0.001）。尺骨前肌质量、股外侧肌质量、VEGF 和bFGF 诊断T2DM 患者肌肉减少症的曲线下面积（AUC）分别为0.661，0.755，0.832 和0.744，联合诊断AUC 为0.911，高于单独检测（P ＜ 0.05）。结论 T2DM 肌肉减少症患者尺骨前肌质量、股外侧肌质量与血清VEGF 和bFGF 水平明显降低，且与肌肉减少症病情程度有关，可以作为肌肉减少症辅助诊断的指标。
Abstract:
Objective To investigate the value of high-frequency ultrasound combined with serum vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in the diagnosis of diabetic patients with sarcopenia. Methods 103 patients with T2DM combined with Sarcopenia(observation group)admitted to Huangshi Central Hospital of Edong Healthcare from June 2018 to December 2019 and 100 healthy volunteers (control group) were selected. According to Sarcopenia disease stage, the patients of observation group were divided into prophase period of Sarcopenia (hereinafter referred to as the prophase, 38 cases), prophase period (hereinafter referred to as Sarcopenia, 34 cases) and severe Sarcopenia period (hereinafter referred to as severe, 31 cases).The thickness and mass of anterior ulnar and lateral muscles were measured by high-frequency ultrasound, and the levels of VEGF and bFGF in serum were determined by ELISA.Pearson correlation analysis was performed to determine the correlation between anterior ulnar muscle mass, lateralis muscle mass, VEGF and bFGF and relative appendicular skeletal muscle mass (RASM), grip strength and stride speed.The receiver operating characteristic Curve (ROC) was used to analyze the value of anterior ulnar muscle mass, lateral femoral muscle mass, VEGF and bFGF in the diagnosis of Sarcopenia in patients with T2DM. Results The levels of anterior ulnar muscle mass（14.32±3.59）, lateral femoral muscle mass（21.01±3.89）, serum VEGF （185.24±20.13 ng/L）and bFGF（11.35±4.52 ng/L）in the observation group were lower than those in the control group（17.45±4.13，25.12±4.25， 236.42±36.49 ng/L，17.64±6.95 ng/L），the differences were statistically significant (t=5.768 ～ 12.557，all P ＜ 0.001). The levels of anterior ulnar muscle mass（11.25±0.42，14.35±2.51）, lateral femoral muscle mass（18.46±0.61，21.34±3.26）, serum VEGF （171.25±3.65 ng/L，178.25±10.43 ng/L）and bFGF （7.42±0.54 ng/L，12.05±2.17 ng/L） in severe and Sarcopenia group were lower than those in the prophase group （16.80±1.03,22.80±1.25，202.91±2.65ng/L, 13.93±1.77 ng/L)，the differences were statistically significant (t=2.560 ～ 41.695，all P ＜ 0.001). The levels of anterior ulnar muscle mass, lateral femoral muscle mass, serum VEGF and bFGF in severe group were lower in the Sarcopenia group，the differences were statistically significant（t=3.542 ～ 11.551，all P ＜ 0.001）.Serum VEGF and bFGF levels were positively correlated with anterior ulnar muscle mass, lateral femoral muscle mass, RASM, grip strength, and step speed (r=0.402 ～ 0.698, all P ＜ 0.05), while the mass of anterior ulnar muscle and lateral femoral muscle were positively correlated with RASM, grip strength, and step speed (r=0.369 ～ 0.719, all P ＜ 0.001).The AUC of anterior ulnar muscle mass, lateral femoral muscle mass, VEGF and bFGF in the diagnosis of Sarcopenia in T2DM patients were 0.661, 0.755, 0.832 and 0.744, respectively, and the combined diagnosis AUC was 0.911, higher than that detected alone (P ＜ 0.05). Conclusion The anterior ulnar muscle mass, lateral femoral muscle mass and serum VEGF and bFGF levels were significantly reduced in T2DM patients with Sarcopenia, which were related to the severity of Sarcopenia, and can be used as an indicator for the auxiliary diagnosis of Sarcopenia.

参考文献/References:

[1] 何清华, 常鑫淼, 孙明晓, 等.2 型糖尿病患者肌肉质量和力量的变化特点[J]. 中华老年医学杂志,2020, 39(5):550-554. HE Qinghua,CHANG Xinmiao,SUN Mingxiao,et al. Characteristics of changes in muscle quality and strength in patients with type 2 diabetes mellitus [J].Chinese Journal of Geriatrics,2020,39 (5):550-554.
[2] CUI Mengzhao, GANG Xiaokun, WANG Gang, et al. A cross-sectional study: Associations between sarcopenia and clinical characteristics of patients with type 2 diabetes[J]. Medicine, 2020, 99(2): e18708.
[3] LI Shumin, LI Hanyu, HU Ying, et al. Ultrasound for measuring the cross-sectional area of biceps brachii muscle in sarcopenia[J]. International Journal of Medical Sciences, 2020, 17(18): 2947-2953.
[4] CANNON D T, RODEWOHL L, ADAMS V, et al. Skeletal myofiber VEGF deficiency leads to mitochondrial, structural, and contractile alterations in mouse diaphragm[J]. Journal of Applied Physiology(Bethesda, Md. : 1985), 2019, 127(5): 1360-1369.
[5] SUN Yiwen, SONG Ruixia, AI Yanliang, et al. APOE2 promotes the development and progression of subretinal neovascularization in age-related macular degeneration via MAPKs signaling pathway[J]. Saudi Journal of Biological Sciences, 2020, 27(10): 2770-2777.
[6] 中华医学会糖尿病学分会. 中国2 型糖尿病防治指南(2017 年版)[J]. 中国糖尿病杂志, 2018, 10(1): 4-67. Chinese Diabetes Society. Chinese guideline for the prevention and treatment of type 2 diabetes mellitus(2017 edition) [J]. Chinese Journal of Diabetes Mellitus,2018,10(1):4-67.
[7] CHEN L K, LIU Likuo, WOO J, et al. Sarcopenia in Asia: Consensus report of the Asian working group for sarcopenia[J]. Journal of the American Medical Directors Association, 2014, 15(2): 95-101.
[8] FUNG F Y, KOH Y L E, MALHOTRA R, et al.Prevalence of and factors associated with sarcopenia among multi-ethnic ambulatory older Asians with type 2 diabetes mellitus in a primary care setting[J]. BMC Geriatrics, 2019, 19(1): 122.
[9] CUI Mengzhao, GANG Xiaokun, WANG Gang, et al. A cross sectional study: Associations between sarcopenia and clinical characteristics of patients with type 2 diabetes[J]. Medicine, 2020, 99(2): e18708.
[10] LARSSON L, DEGENS H, LI M, et al. Sarcopenia:Aging-related loss of muscle mass and function[J].Physiological Reviews, 2019, 99(1): 427-511.
[11] 吕珊, 狄文娟, 朱思平, 等．血糖水平与超声检测局部肌肉量及肌肉质量的相关性研究[J]. 中华糖尿病杂志, 2020, 12(10):824-829. L? Shan,DI Wenjuan,ZHU Siping,et al. Correlation study between blood glucose level and local muscle mass measured by ultrasound [J]. Chinese Journal of Diabetes Mellitus, 2020,12(10):824-829.
[12] 刘学芳, 霍豆, 赵茜, 等. 急性脑梗死患者血清VEGF,SAA 和Lp-PLA2 联合检测的临床研究[J]. 现代检验医学杂志, 2018, 33(4):76-80. LIU Xuefang, HUO Dou, ZHAO Qian, et al. Diagnostic value of combined detection of VEGF,SAA and Lp-PLA2 for acute cerebral infarction[J]. Journal of Modern Laboratory Medicine , 2018, 33(4):76-80.
[13] SUN Dawei, WANG Wenying, WANG Xintao, et al.bFGF plays a neuroprotective role by suppressing excessive autophagy and apoptosis after transient global cerebral ischemia in rats[J]. Cell Death & Disease,2018, 9(2): 172.
[14] DURAN C L, ABBEY C A, BAYLESS K J.Establishment of a three-dimensional model to study human uterine angiogenesis[J]. Molecular Human Reproduction, 2018, 24(2): 74-93.
[15] PHILLIPS A C, CARROLL D, GALE C R, et al.Cortisol, DHEA sulphate, their ratio, and all-cause and cause-specific mortality in the Vietnam Experience Study[J]. European Journal of Endocrinology, 2010,163(2): 285-292.
[16] SAKITA M, MURAKAMI S, FUJINO H, et al.Remodeling of myelinated fibers and internal capillaries in distal peripheral nerves following aerobic exercise in aged rats[J]. Journal of Applied Physiology (Bethesda,Md. : 1985), 2018, 125(4): 1051-1061.
[17] GUO Dongqing, WANG Qiyan, LI Chun, et al.VEGF stimulated the angiogenesis by promoting the mitochondrial functions[J]. Oncotarget, 2017, 8(44):77020-77027.
[18] ZHENG Yan, KONG Jian, LI Qun, et al. Role of miRNAs in skeletal muscle aging[J]. Clinical Interventions in Aging, 2018, 13: 2407-2419.
[19] ZHU Zhongxi, CAI Wanhui, WANG Tao, et al. bFGFregulating MAPKs are involved in high glucosemediated ROS production and delay of vascular endothelial cell migration[J]. PLoS One, 2015, 10(12):e0144495.
[20] LI Rui, LI Yiyang, WU Yanqing, et al. Heparinpoloxamer thermosensitive hydrogel loaded with bFGF and NGF enhances peripheral nerve regeneration in diabetic rats[J]. Biomaterials, 2018, 168: 24-37.

相似文献/References:

[1]齐冰,孙蔚.肺间质纤维化并发肺气肿病人血清TGF-β，VEGF和IGF-I作用、意义及与吸烟相关性研究[J].现代检验医学杂志,2015,30(06):109.[doi:10.3969/j.issn.1671-7414.2015.06.033]
　QI Bing,SUN Wei.Research on the Significance and Role of the Serum TGF-β，VEGF， IGF-Ⅰand Its Correlation with Smoking of the Patients with Combined Pulmonary Fibrosis and Emphysema[J].Journal of Modern Laboratory Medicine,2015,30(04):109.[doi:10.3969/j.issn.1671-7414.2015.06.033]
[2]宋事竑,曾而明.血清淀粉样蛋白A 与血管新生最新研究进展[J].现代检验医学杂志,2020,35(02):157.[doi:10.3969/j.issn.1671-7414.2020.02.043]
　SONG Shi-hong,ZENG Er-ming.Recent Advances in Serum Amyloid A and Angiogenesis[J].Journal of Modern Laboratory Medicine,2020,35(04):157.[doi:10.3969/j.issn.1671-7414.2020.02.043]
[3]张　劲,明　媚.增生性糖尿病视网膜病变患者玻璃体、房水和血浆中VEGF表达与IL-6，IL-8和TNF-α水平的相关性研究[J].现代检验医学杂志,2021,36(04):55.[doi:10.3969/j.issn.1671-7414.2021.04.012]
　ZHANG Jin,MING Mei.Correlation of VEGF Expression with IL-6, IL-8 and TNF-α Levels inVitreous Body, Aqueous Humor and Plasma of Patients with ProliferativeDiabetic Retinopathy[J].Journal of Modern Laboratory Medicine,2021,36(04):55.[doi:10.3969/j.issn.1671-7414.2021.04.012]
[4]冯　健,凌秀婷,施俊柱,等.子痫前期孕妇HIF-1a基因rs11549467G/A位点多态性和血清HIF-1a及VEGF水平表达与病情严重程度的相关性分析[J].现代检验医学杂志,2022,37(03):21.[doi:10.3969/j.issn.1671-7414.2022.03.005]
　FENG Jian,LING Xiu-ting,SHI Jun-zhu,et al.Correlation of HIF-1a Gene rs11549467G/A Local Polymorphism and Levels of HIF-1a and VEGF with the Severity of Preeclampsia in Pregnant Women[J].Journal of Modern Laboratory Medicine,2022,37(04):21.[doi:10.3969/j.issn.1671-7414.2022.03.005]

备注/Memo

备注/Memo:
基金项目： 湖北省卫健委联合基金（WJ2019H157）。
作者简介：徐珍望 （1980-），女，本科，主治医师，研究方向：超声诊断及超声介入诊疗，E-mail:2827485925@qq.com。
通讯作者：刘佳 （1982-），女，本科，副主任医师，研究方向：超声诊断及超声介入诊疗。
更新日期/Last Update: 1900-01-01