目的: 探讨2型糖尿病(T2DM)微血管病变的影响因素以及血清胱抑素C(Cys C)与T2DM微血管病变的关系。方法: 选取2020年9月至2022年6月收治的830例T2DM患者作为研究对象,根据是否伴有微血管并发症分为观察组(2型糖尿病微血管病变组)和对照组(单纯2型糖尿病组),比较2组患者的基本资料和生化指标。结果: 观察组患者高血压患病率、糖尿病病程、年龄高于对照组(P＜0.05);观察组糖化血红蛋白(HbA1c)、空腹血糖(FPG)、血清肌酐(Scr)、尿酸(UA)、血清胱抑素C(Cys C)、低密度脂蛋白(LDL)、甘油三酯(TG)、血清总胆固醇(TC)、载脂蛋白A(APOA)、载脂蛋白B(APOB)水平高于对照组,高密度脂蛋白(HDL)水平低于对照组(P＜0.05);二元logistic回归分析显示,高血压、病程、HbA1c、FPG、Cys C、HDL、APOA是T2DM微血管病变的影响因素;受试者工作曲线(ROC)结果显示,Cys C可作为T2DM微血管病变的潜在诊断指标(AUC=0.707,P=0.000)。结论: HbA1c、FPG、HDL、APOA、高血压、糖尿病病程、Cys C等因素是T2DM微血管病变的独立影响因素,血清Cys C可作为其潜在诊断指标。T2DM微血管病变管理的关注点不仅要控制血糖,更需要从新的角度寻找预防和治疗靶点,为T2DM微血管病变的防治提供新思路。
Objective: To investigate the influencing factors and roles of serum Cys C in microangiopathy of type 2 diabetes mellitus.Methods: A total of 830 patients with T2DM admitted from September 2020 to June 2022 were selected as the research objects, and the patients were divided into observation group (type 2 diabetic microangiopathy group) and control group (simple type 2 diabetes group) according to whether they had microangiopathy. The basic data and biochemical indexes of the two groups were compared. Results: The prevalence of hypertension, duration of diabetes and age in the observation group were higher than those in the control group (P＜0.05). The levels of glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), serum creatinine (Scr), uric acid (UA), serum cystatin C (Cys C), low density lipoprotein (LDL), triglyceride (TG), serum total cholesterol (TC), apolipoprotein A (APOA) and apolipoprotein B (APOB) in the observation group were higher than those in the control group, and the level of high density lipoprotein (HDL) was lower than that in the control group (P＜0.05). Binary logistic regression analysis showed that hypertension, course of disease, HbA1c, FPG, Cys C, HDL and APOA were the influencing factors of T2DM microangiopathy. The receiver operating curve (ROC) results showed that Cys C could be used as a potential diagnostic indicator for T2DM microvascular disease (AUC=0.707, P=0.000). Conclusion: HbA1c, FPG, HDL, APOA, hypertension, duration of diabetes, Cys C and other factors are independent influencing factors of T2DM microangiopathy, and serum Cys C can be used as a potential diagnostic indicator. The focus of T2DM microangiopathy management is not only to control blood glucose, but also to find prevention and treatment targets from a new perspective, providing new ideas for the prevention and treatment of T2DM microangiopathy.
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