2 型糖尿病患者 Lp-PLA2 对冠心病的预测价值:一项观察性研究

IF 0.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM International Journal of Diabetes in Developing Countries Pub Date : 2024-01-24 DOI:10.1007/s13410-024-01312-w
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引用次数: 0

摘要

摘要 目的 2 型糖尿病(T2DM)是一种以血糖水平升高为特征的慢性疾病,可导致多种并发症,包括冠状动脉疾病(CAD)。Lp-PLA2 是一种与血液循环中的低密度脂蛋白(LDL)颗粒相关的促炎酶,被认为是冠状动脉疾病风险的生物标志物。 方法 本研究旨在评估患有和未患有冠状动脉疾病(CAD)的 2 型糖尿病(T2DM)患者血清脂蛋白相关磷脂酶 A2(Lp-PLA2)水平的诊断效用。利用接收器操作特征曲线(ROC)评估了 Lp-PLA2 的诊断效果。 结果 无心血管疾病的 T2DM 患者的脂蛋白-PLA2 水平(146.7 纳克/毫升 88.4)远高于 HC(103.3 纳克/毫升 21.7)和 T2DM + CAD(124.31 纳克/毫升 11.7)。在无 CAD 的 T2DM 患者中,Lp-PLA2 水平与年龄、Hba1c、低密度脂蛋白或脂蛋白(a)之间没有明显的统计学相关性。经多元线性回归分析确定,Lp-PLA2 水平与年龄(p = 0.97)、HbA1c(p = 0.41)、低密度脂蛋白(p = 0.59)或脂蛋白(a)(p = 0.56)无明显相关性。经计算,无 CAD 的 T2DM 患者 Lp-PLA2 的曲线下面积 (AUC) 为 0.76,置信区间 (CI) 为 95%。115 ng/mL 临界点的灵敏度和特异度分别为 0.70 和 0.68。对于 T2DM + CAD 患者,AUC 为 0.73,置信区间为 95%,阈值点为 115 ng/mL,灵敏度和特异性分别为 0.73 和 0.75。 结论 在患有或不患有 CAD 的 T2DM 患者中,血清 Lp-PLA2 浓度可作为诊断标志物。115纳克/毫升的临界值具有极佳的灵敏度和特异性,尤其是在无 CAD 的 T2DM 患者中。这一发现表明,Lp-PLA2 可作为一种诊断工具,用于识别 T2DM 患者中的 CAD 高危人群。
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Predictive value of Lp-PLA2 for coronary artery disease in type 2 diabetes mellitus patients: an observational study

Abstract

Objective

Type 2 diabetes mellitus (T2DM) is a chronic disease characterized by elevated blood glucose levels, which can result in a variety of complications, including coronary artery disease (CAD). Lp-PLA2 is a proinflammatory enzyme associated with low-density lipoprotein (LDL) particles in the circulation and is thought to be a biomarker for CAD risk.

Methods

The purpose of this investigation was to evaluate the diagnostic utility of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) levels in type 2 diabetes mellitus (T2DM) patients with and without coronary artery disease (CAD). Utilizing receiver operating characteristic (ROC) curves, the diagnostic efficacy of Lp-PLA2 was evaluated.

Results

Lp-PLA2 levels were substantially higher in T2DM patients without cardiovascular disease (146.7 ng/mL 88.4) compared to HC (103.3 ng/mL 21.7) and T2DM + CAD (124.31 ng/mL 11.7). There was no statistically significant correlation between Lp-PLA2 levels and age, Hba1c, LDL, or Lp(a) in T2DM patients without CAD. Lp-PLA2 levels were not significantly associated with age (p = 0.97), HbA1c (p = 0.41), LDL (p = 0.59), or Lp(a) (p = 0.56), as determined by multiple linear regression analysis. The area under the curve (AUC) for Lp-PLA2 in T2DM without CAD was calculated to be 0.76, with a 95% confidence interval (CI). The sensitivity and specificity of a termination point of > 115 ng/mL were 0.70 and 0.68, respectively. For patients with T2DM + CAD, the AUC was 0.73 with a 95% confidence interval, and a threshold point of > 115 ng/mL yielded sensitivity and specificity values of 0.73 and 0.75, respectively.

Conclusions

In T2DM patients with or without CAD, serum Lp-PLA2 concentrations may serve as a diagnostic marker. The cutoff value of > 115 ng/mL exhibited excellent sensitivity and specificity, especially in T2DM patients without CAD. This finding suggests the clinical utility of Lp-PLA2 as a diagnostic tool for identifying those at risk for CAD in the context of T2DM.

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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
109
审稿时长
6 months
期刊介绍: International Journal of Diabetes in Developing Countries is the official journal of Research Society for the Study of Diabetes in India. This is a peer reviewed journal and targets a readership consisting of clinicians, research workers, paramedical personnel, nutritionists and health care personnel working in the field of diabetes. Original research articles focusing on clinical and patient care issues including newer therapies and technologies as well as basic science issues in this field are considered for publication in the journal. Systematic reviews of interest to the above group of readers are also accepted.
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