摘要
目的 探讨T2DM患者血清C1q肿瘤坏死因子相关蛋白9(CTRP9)与心血管自主神经病变(CAN)的相关性。方法 选取2018年12月至2020年12月于南京市溧水区人民医院内分泌科住院的T2DM患者318例,根据标准心血管自主神经反射试验(CARTs)分为单纯T2DM组(T2DM)116例、T2DM合并早期CAN组(ECAN)107例及T2DM合并CAN组(CAN)95例。结果 CAN组血清CTRP9低于ECAN组,ECAN组血清CTRP9低于T2DM组(P<0.05)。CTRP9三分位(≤3.12 ng/ml、3.12~3.84 ng/ml和>3.84 ng/ml)比较,CART评分、卧-立收缩压差和CAN发生率逐渐降低(P<0.05),深呼吸心率差值、Valsalva R-R比值、立-卧心率差值逐渐升高(P<0.05)。Pearson相关分析显示,CTRP9与深呼吸心率差值、Valsalva R-R比值和立-卧心率差值呈正相关(P<0.05),与卧-立收缩压差呈负相关(P<0.05)。Logistic回归分析显示,CTRP9是CAN的保护因素。受试者工作特征(ROC)曲线分析显示,CTRP9预测CAN的ROC曲线下面积为0.833(P<0.05)。结论 T2DM合并CAN患者血清CTRP9降低,CTRP9有望成为早期诊断CAN重要的生物标志物。
Objective To investigate the correlation between serum C1q tumor necrosis factor related protein 9(CTRP9)level and cardiac autonomic neuropathy(CAN)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 318 patients with T2DM from December 2018 to December 2020 were selected. According to standard cardiovascular autonomic reflex tests(CARTs),they were divided into T2DM group(T2DM,n=116),early CAN group(ECAN,n=107),and CAN group(CAN,n=95).Results Compared with T2DM group,the levels of serum CTRP9 were decreased in ECAN group and even lower in CAN group(P<0. 05). With the increase of serum CTRP9(tertile range:≤3. 12 ng/ml,3. 12~3. 84 ng/ml and >3. 84 ng/ml),the CART score,horizontal-vertical systolic pressure difference and the incidence of CAN gradually decreased(P<0. 05),while deep breathing heart rate difference,Valsalva R-R ratio and-Lying heart rate difference increased(P<0. 05). Pearson correlation analysis showed that CTRP9 was positively correlated with deep breathing heart rate difference,Valsalva RR ratio,and vertical-recumbent heart rate difference(P<0. 05),and was negatively correlated with lying-to-stand systolic pressure difference(P<0. 05). Logistic regression analysis showed that CTRP9 was a protective factor for CAN. ROC analysis showed that the AUC of CAN predicted by CTRP9 level was 0. 833(P<0. 05).Conclusion Decreased serum CTRP9 may be an important biomarker for early diagnosis of CAN in T2DM patients.
作者
武银铃
李红宁
黄玉婷
俞淑琴
蔡祥增
孙树乾
陈娟
WU Yinling;LI Hongning;HUANG Yuting;SUN Shuqian(Department of Endocrinology,People’s Hospital of Lishui District,Nanjing 211200,China)
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2022年第7期496-500,共5页
Chinese Journal of Diabetes
基金
江苏省卫生健康委2019年医学科研项目(H201906)。
